Active NPI
Jeffrey Alan Donnelly, RPH
- Pharmacist
- Mesa, AZ
National Provider Identifier
1992727192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8434
- Practice address
- 1920 W Broadway Rd
Mesa, AZ 85202-1127 - Phone
- (480) 833-0731
- Fax
- (480) 835-9167
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 8434 | AZ | Primary |
Addresses
Primary practice location
1920 W Broadway Rd
Mesa, AZ 85202-1127
Mailing address
2319 W Lobo Ave
Mesa, AZ 85202-6445
Phone (480) 766-2340
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8434 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992727192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2319 W LOBO AVE",
"city": "MESA",
"state": "AZ",
"postal_code": "852026445",
"telephone_number": "480-766-2340",
"fax_number": "480-831-0611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 W BROADWAY RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852021127",
"telephone_number": "480-833-0731",
"fax_number": "480-835-9167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNELLY",
"first_name": "JEFFREY",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "8434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.