Active NPI
Jocelin Q Phan, PHARM D.
- Pharmacist
- Surprise, AZ
National Provider Identifier
1861035990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S024353
- Practice address
- 15514 W Waddell Rd
Surprise, AZ 85379-5167 - Phone
- (623) 215-0544
- NPI assigned
- Oct 22, 2019
- 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 | S024353 | AZ | Primary |
Addresses
Primary practice location
15514 W Waddell Rd
Surprise, AZ 85379-5167
Mailing address
15514 W Waddell Rd
Surprise, AZ 85379-5167
Other practice location 1
20266 N Lake Pleasant Rd
Peoria, AZ 85382-9711
Phone (623) 561-5422
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 |
|---|---|---|---|
| S024353 | AZ | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571702400000",
"number": "1861035990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15514 W WADDELL RD",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853795167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15514 W WADDELL RD",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853795167",
"telephone_number": "623-215-0544"
}
],
"practiceLocations": [
{
"address_1": "20266 N Lake Pleasant Rd",
"address_purpose": "LOCATION",
"city": "Peoria",
"state": "AZ",
"postal_code": "853829711",
"country_code": "US",
"telephone_number": "623-561-5422",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHAN",
"first_name": "JOCELIN",
"middle_name": "Q",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-22",
"last_updated": "2019-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S024353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.