Individual provider Active NPI

Jason Fenker, PHARMD

  • Pharmacist
  • Casa Grande, AZ
National Provider Identifier
1760884829
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S015605 Issued in AZ
Practice address
951 N Promenade Pkwy
Casa Grande, AZ 85194-5400
Phone
(520) 413-6971
NPI assigned
Sep 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S015605 AZ Primary

Addresses

Primary practice location

951 N Promenade Pkwy
Casa Grande, AZ 85194-5400

Mailing address

951 N Promenade Pkwy
Casa Grande, AZ 85194-5400

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
S015605AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1411171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1760884829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 N PROMENADE PKWY",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851945400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 N PROMENADE PKWY",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851945400",
            "telephone_number": "520-413-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENKER",
        "first_name": "JASON",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-20",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S015605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; 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.