Active NPI
Wayne Erichsen
- Pharmacist
- Mesa, AZ
National Provider Identifier
1811309263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6725
- Practice address
- 1212 S Greenfield Rd
Mesa, AZ 85206-2792 - Phone
- (480) 654-8920
- NPI assigned
- May 20, 2014
- Sex
- Male
- 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 | 6725 | AZ | Primary |
Addresses
Primary practice location
1212 S Greenfield Rd
Mesa, AZ 85206-2792
Mailing address
5635 S Rocky Point Rd
Tempe, AZ 85283-2133
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6725 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400544000000",
"number": "1811309263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5635 S ROCKY POINT RD",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852832133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 S GREENFIELD RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852062792",
"telephone_number": "480-654-8920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICHSEN",
"first_name": "WAYNE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-20",
"last_updated": "2014-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "6725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.