Individual provider Active NPI

David Iverson

  • Pharmacist
  • North Liberty, IA
National Provider Identifier
1780201236
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
23612 Issued in IA
Practice address
625 Pacha Pkwy
North Liberty, IA 52317-4831
Phone
(319) 499-6006
NPI assigned
Jul 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 23612 IA Primary

Addresses

Primary practice location

625 Pacha Pkwy
North Liberty, IA 52317-4831

Mailing address

625 Pacha Pkwy
North Liberty, IA 52317-4831

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
23612IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Mar 27, 2022 Accepting new patients
Walgreen Co PastSince Jul 5, 2020 Accepting new patients

Locations

625 Pacha Pkwy
North Liberty, IA 52317
Phone (319) 499-6006

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": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1780201236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 PACHA PKWY",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523174831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 PACHA PKWY",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523174831",
            "telephone_number": "319-499-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERSON",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "23612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.