Individual provider Active NPI

Mackenzie Obermeyer, PHARMD

  • Pharmacist
  • Wichita, KS
National Provider Identifier
1710455308
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2018035044 Issued in MO
Practice address
1035 N Emporia Ave Ste 170
Wichita, KS 67214-2999
Phone
(316) 263-6233
NPI assigned
Nov 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1-106217 KS
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 2018035044 MO Primary

Addresses

Primary practice location

1035 N Emporia Ave Ste 170
Wichita, KS 67214-2999

Mailing address

1035 N Emporia Ave Ste 170
Wichita, KS 67214-2999
Phone (316) 263-6233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
1-106217KSMDPharmacist
2018035044MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Consumer'S Pharmacy Inc PastSince Jan 8, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1710455308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 N EMPORIA AVE STE 170",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142999",
            "telephone_number": "316-263-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 N EMPORIA AVE STE 170",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142999",
            "telephone_number": "316-263-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERMEYER",
        "first_name": "MACKENZIE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-106217",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2018035044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.