Dane Pebler, PHARMD

Key facts

NPI

1891143293

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

S021942 (AZ)

Practice address

10324 E Riggs Rd
Sun Lakes, AZ 85248-7625

Phone

(480) 895-0761

NPI assigned

May 26, 2016

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Pharmacy

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 25, 2016.

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1891143293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 E PEBBLE BEACH DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825576",
            "telephone_number": "480-331-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10324 E RIGGS RD",
            "city": "SUN LAKES",
            "state": "AZ",
            "postal_code": "852487625",
            "telephone_number": "480-895-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEBLER",
        "first_name": "DANE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S021942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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