Individual provider Active NPI

Stephen Brian McQueen, R.PH.

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1780914994
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11050 Issued in AZ
Practice address
2075 W Pinnacle Peak Rd
Suite 130
Phoenix, AZ 85027-1217
Phone
(623) 215-0407
Fax
(623) 215-0423
NPI assigned
Jan 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11050 AZ Primary
Pharmacist 183500000X 5302029259 MI

Addresses

Primary practice location

2075 W Pinnacle Peak Rd
Suite 130
Phoenix, AZ 85027-1217

Mailing address

2075 W Pinnacle Peak Rd
Suite 130
Phoenix, AZ 85027-1217
Phone (623) 215-0407

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302029259MIMDPharmacist
11050AZMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1780914994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 W PINNACLE PEAK RD",
            "address_2": "SUITE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271217",
            "telephone_number": "623-215-0407",
            "fax_number": "623-215-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 W PINNACLE PEAK RD",
            "address_2": "SUITE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271217",
            "telephone_number": "623-215-0407",
            "fax_number": "623-215-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUEEN",
        "first_name": "STEPHEN",
        "middle_name": "BRIAN",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "11050",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302029259",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.