Active NPI
Azam Ghanadian
- Pharmacist
- Wichita, KS
National Provider Identifier
1992174809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1-13097
- Practice address
- 11411 E Kellogg Dr
Wichita, KS 67207-1928 - Phone
- (316) 683-1023
- Fax
- (316) 683-1023
- NPI assigned
- Sep 21, 2015
- Last updated
- Sep 21, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1-13097 | KS | Primary |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 1-13097 | KS |
Addresses
Primary practice location
11411 E Kellogg Dr
Wichita, KS 67207-1928
Mailing address
11411 E Kellogg Dr
Wichita, KS 67207-1928
Phone (316) 683-1023
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 |
|---|---|---|---|
| 1-13097 | KS | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442793600000",
"number": "1992174809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11411 E KELLOGG DR",
"city": "WICHITA",
"state": "KS",
"postal_code": "672071928",
"telephone_number": "316-683-1023",
"fax_number": "316-683-1023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11411 E KELLOGG DR",
"city": "WICHITA",
"state": "KS",
"postal_code": "672071928",
"telephone_number": "316-683-1023",
"fax_number": "316-683-1023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHANADIAN",
"first_name": "AZAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-21",
"last_updated": "2015-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "1-13097",
"primary": true
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "KS",
"license": "1-13097",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.