Active NPI
Timothy Edgar Green, PHARMD, RPH
- Pharmacist
- Phoenix, AZ
National Provider Identifier
1730908971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S027273
- Practice address
- 16806 N 7TH St
Phoenix, AZ 85022-2662 - Phone
- (602) 794-3602
- Fax
- (602) 794-3612
- NPI assigned
- Oct 4, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S027273 | AZ | Primary |
Addresses
Primary practice location
16806 N 7TH St
Phoenix, AZ 85022-2662
Mailing address
16806 N 7TH St
Phoenix, AZ 85022-2662
Phone (602) 794-3602
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S027273 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728000000000",
"number": "1730908971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16806 N 7TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850222662",
"telephone_number": "602-794-3602",
"fax_number": "602-794-3612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16806 N 7TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850222662",
"telephone_number": "602-794-3602",
"fax_number": "602-794-3612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "TIMOTHY",
"middle_name": "EDGAR",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-10-04",
"last_updated": "2024-10-04",
"certification_date": "2024-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S027273",
"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 Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.