Individual provider Active NPI

Cody Phillips, PHARMD

  • Pharmacist
  • Cheyenne, WY
National Provider Identifier
1730588641
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
3154 Issued in WY
Practice address
489 Road 138
Cheyenne, WY 82007-9658
Phone
(307) 421-0512
NPI assigned
Aug 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 3154 WY Primary

Addresses

Primary practice location

489 Road 138
Cheyenne, WY 82007-9658

Mailing address

489 Road 138
Cheyenne, WY 82007-9658
Phone (307) 421-0512

Other identifiers 1

IdentifierTypeStateIssuer
3154OtherWYPHARMACY

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
3154WYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408060800000",
    "number": "1730588641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 ROAD 138",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820079658",
            "telephone_number": "307-421-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 ROAD 138",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820079658",
            "telephone_number": "307-421-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CODY",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "3154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY",
            "identifier": "3154",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2014; 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.