Individual provider Active NPI

Kenneth Scott Woodall, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Queen Creek, AZ
National Provider Identifier
1821781113
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
S023277 Issued in AZ
Practice address
22265 E Queen Creek Rd
Queen Creek, AZ 85142-9801
Phone
(602) 457-4320
NPI assigned
Jun 1, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X S023277 AZ Primary
Pharmacist 183500000X 017803 KY
Pharmacist 183500000X 03334886 OH

Addresses

Primary practice location

22265 E Queen Creek Rd
Queen Creek, AZ 85142-9801

Mailing address

23056 E Camina Buena Vis
Queen Creek, AZ 85142-1325
Phone (513) 403-3170

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

LicenseStateTypeSpecialty
S023277AZMDPharmacist
017803KYMDPharmacist
03334886OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Smith'S Food & Drug Centers Inc Past Accepting new patients
Smiths Food & Drug Centers Inc PastSince Jan 14, 2024 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": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1821781113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23056 E CAMINA BUENA VIS",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421325",
            "telephone_number": "513-403-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22265 E QUEEN CREEK RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429801",
            "telephone_number": "602-457-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "KENNETH",
        "middle_name": "SCOTT",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-01",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AZ",
            "license": "S023277",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "017803",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03334886",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.