Individual provider Active NPI

Valentina Douangdara, PHARMD

  • Pharmacist
  • Salt Lake City, UT
National Provider Identifier
1750031761
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8789362-1701 Issued in UT
Practice address
145 E 1300 S Ste 103
Salt Lake City, UT 84115-6118
Phone
(385) 212-2934
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8789362-1701 UT Primary

Addresses

Primary practice location

145 E 1300 S Ste 103
Salt Lake City, UT 84115-6118

Mailing address

145 E 1300 S Ste 103
Salt Lake City, UT 84115-6118

Other practice location 1

3540 S 4000 W
West Valley City, UT 84120-3260
Phone (801) 969-8261

Other practice location 2

4401 Harrison Blvd
Ogden, UT 84403-3195
Phone (801) 387-2800

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
8789362-1701UTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Genoa Healthcare LLC PastSince Mar 27, 2022 Accepting new patients
Genoa Healthcare LLC PastSince Mar 27, 2022 Accepting new patients

Organizations & group practices 2

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": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1750031761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E 1300 S STE 103",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841156118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 E 1300 S STE 103",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841156118",
            "telephone_number": "385-212-2934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3540 S 4000 W",
            "address_purpose": "LOCATION",
            "city": "West Valley City",
            "state": "UT",
            "postal_code": "841203260",
            "country_code": "US",
            "telephone_number": "801-969-8261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4401 Harrison Blvd",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844033195",
            "country_code": "US",
            "telephone_number": "801-387-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUANGDARA",
        "first_name": "VALENTINA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "8789362-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.