Individual provider Active NPI

Lori Lynn Nelson Allen

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1922666213
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S9955 Issued in AZ
Practice address
16515 S 40TH St Ste 123
Phoenix, AZ 85048-0559
Phone
(480) 706-0620
Fax
(480) 706-0489
NPI assigned
May 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S9955 AZ Primary

Addresses

Primary practice location

16515 S 40TH St Ste 123
Phoenix, AZ 85048-0559

Mailing address

16515 S 40TH St Ste 123
Phoenix, AZ 85048-0559
Phone (480) 706-0620

Other identifiers 1

IdentifierTypeStateIssuer
S009955OtherAZARIZONA BOARD OF PHARMACY LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Lori@Mixturesrx.com Direct

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

LicenseStateTypeSpecialty
S9955AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1922666213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16515 S 40TH ST STE 123",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480559",
            "telephone_number": "480-706-0620",
            "fax_number": "480-706-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16515 S 40TH ST STE 123",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480559",
            "telephone_number": "480-706-0620",
            "fax_number": "480-706-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "LORI",
        "middle_name": "LYNN NELSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S9955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA BOARD OF PHARMACY LICENSE",
            "identifier": "S009955",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lori@Mixturesrx.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "16515 S 40th St Ste 123",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850480559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.