Individual provider Active NPI

Eric Wyatt Leishman, PHARMD

  • Ambulatory Care Pharmacist
  • South Jordan, UT
National Provider Identifier
1841773041
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
7343428-1701 Issued in UT
Practice address
5126 W Daybreak Pkwy
South Jordan, UT 84009-5994
Phone
(801) 213-4565
NPI assigned
Sep 13, 2018
Last updated
Jul 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH-0016103 OR
Ambulatory Care Pharmacist 1835P2201X 7343428-1701 UT Primary

Addresses

Primary practice location

5126 W Daybreak Pkwy
South Jordan, UT 84009-5994

Mailing address

5126 W Daybreak Pkwy
South Jordan, UT 84009-5994
Phone (801) 213-4565

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
RPH-0016103ORMDPharmacist
7343428-1701UTMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1841773041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5126 W DAYBREAK PKWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840095994",
            "telephone_number": "801-213-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5126 W DAYBREAK PKWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840095994",
            "telephone_number": "801-213-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISHMAN",
        "first_name": "ERIC",
        "middle_name": "WYATT",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-13",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0016103",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "UT",
            "license": "7343428-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.