Active NPI
Kenneth Purdy
- Pharmacist
- Spokane Valley, WA
National Provider Identifier
1992072383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00070553
- Practice address
- 12312 E Sprague Ave
Spokane Valley, WA 99216-0720 - Phone
- (509) 921-0659
- Fax
- (509) 921-2152
- NPI assigned
- Nov 29, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | PH00070553 | WA | Primary |
Addresses
Primary practice location
12312 E Sprague Ave
Spokane Valley, WA 99216-0720
Mailing address
12312 E Sprague Ave
Spokane Valley, WA 99216-0720
Phone (509) 921-0659
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH00070553 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322524800000",
"number": "1992072383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12312 E SPRAGUE AVE",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992160720",
"telephone_number": "509-921-0659",
"fax_number": "509-921-2152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12312 E SPRAGUE AVE",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992160720",
"telephone_number": "509-921-0659",
"fax_number": "509-921-2152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURDY",
"first_name": "KENNETH",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-29",
"last_updated": "2011-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00070553",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.