Individual provider Active NPI

Joen Redd N Legislador

  • Pharmacist
  • Tamuning, GU
National Provider Identifier
1770125148
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH0311 Issued in GU
Practice address
353 Chalan San Antonio Ste 100
Tamuning, GU 96913-3300
Phone
(671) 649-1977
Fax
(671) 646-5338
NPI assigned
Oct 17, 2019
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH0311 GU Primary

Addresses

Primary practice location

353 Chalan San Antonio Ste 100
Tamuning, GU 96913-3300

Mailing address

353 Chalan San Antonio
Photo Town Plaza Suite 100
Tamuning, GU 96913-3392

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

State licenses

LicenseStateTypeSpecialty
PH0311GUMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1770125148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 CHALAN SAN ANTONIO",
            "address_2": "PHOTO TOWN PLAZA SUITE 100",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 CHALAN SAN ANTONIO STE 100",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133300",
            "telephone_number": "671-649-1977",
            "fax_number": "671-646-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGISLADOR",
        "first_name": "JOEN REDD",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-17",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GU",
            "license": "PH0311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.