Kyle Jordan Lanham, PHARMD

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

S025465 Issued in AZ

Practice address

901 Willow Lake Rd
Prescott, AZ 86301-4617

Phone

(928) 771-0278

NPI assigned

Sep 28, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• German Dobson CVS LLC

  dba CVS Pharmacy #10147

  • Pharmacy
  • Prescott, AZ
  • NPI 1255736120
  NPD (past)
• German Dobson CVS LLC

  dba CVS Pharmacy #17927

  • Pharmacy
  • Queen Creek, AZ
  • NPI 1639053374
  NPD (past)

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1770255838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15457 W SHANGRI LA RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853795387",
            "telephone_number": "850-737-1168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WILLOW LAKE RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863014617",
            "telephone_number": "928-771-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANHAM",
        "first_name": "KYLE",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "S025465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan D Langerak, MD
• Donald C Langford, M.C.
• Kimberly Langford, LPC
• Tyler Langford, LPC
• Erin Langmead, PA
• Alison Lapham, RRT
• Tamra Larrabee, L.AC.
• Elizabeth Larson, DNP, APRN, AGACNP-BC
• Don K Larue, MPAS,APA-C
• Timothy John Laskowski, BSW, PHD

• Community/Retail Pharmacy in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.