Individual provider Active NPI

Jared Wayne Roswurm, PHARM.D.

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1730480807
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15500 Issued in AZ
Practice address
4005 E Chandler Blvd
Phoenix, AZ 85048-8888
Phone
(480) 759-4479
Fax
(480) 759-8644
NPI assigned
Nov 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15500 AZ Primary

Addresses

Primary practice location

4005 E Chandler Blvd
Phoenix, AZ 85048-8888

Mailing address

4005 E Chandler Blvd
Phoenix, AZ 85048-8888
Phone (480) 759-4479

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
15500AZMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288915200000",
    "number": "1730480807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 E CHANDLER BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850488888",
            "telephone_number": "480-759-4479",
            "fax_number": "480-759-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 E CHANDLER BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850488888",
            "telephone_number": "480-759-4479",
            "fax_number": "480-759-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSWURM",
        "first_name": "JARED",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "15500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.