Individual provider Active NPI

Lisa M Sanders, RPH

  • Pharmacist
  • Des Moines, IA
National Provider Identifier
1972880342
Registry record updated Nov 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16629 Issued in IA
Practice address
5901 Douglas Ave
Des Moines, IA 50322-3303
Phone
(515) 331-0599
Fax
(515) 331-0599
NPI assigned
Nov 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16629 IA Primary

Addresses

Primary practice location

5901 Douglas Ave
Des Moines, IA 50322-3303

Mailing address

5901 Douglas Ave
Des Moines, IA 50322-3303
Phone (515) 331-0599

Other identifiers 1

IdentifierTypeStateIssuer
0464925MedicaidIA

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
16629IAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1321142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321142400000",
    "number": "1972880342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 DOUGLAS AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503223303",
            "telephone_number": "515-331-0599",
            "fax_number": "515-331-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 DOUGLAS AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503223303",
            "telephone_number": "515-331-0599",
            "fax_number": "515-331-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-13",
        "last_updated": "2011-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "16629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0464925",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2011; 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.