Active NPI
Praicy Mathew, PHARMD
- Pharmacist
- Oklahoma City, OK
National Provider Identifier
1790290542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17657
- Practice address
- 8917 NE 23Rd St
Oklahoma City, OK 73141-2245 - Phone
- (405) 769-2712
- NPI assigned
- Dec 1, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17657 | OK | Primary |
Addresses
Primary practice location
8917 NE 23Rd St
Oklahoma City, OK 73141-2245
Mailing address
1008 Preston Park Dr
Yukon, OK 73099-2173
Phone (405) 464-8828
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17657 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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": "1512086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512086400000",
"number": "1790290542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 PRESTON PARK DR",
"city": "YUKON",
"state": "OK",
"postal_code": "730992173",
"telephone_number": "405-464-8828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8917 NE 23RD ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731412245",
"telephone_number": "405-769-2712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEW",
"first_name": "PRAICY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-01",
"last_updated": "2017-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "17657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.