IndividualActive
Mariah Black, PHARMD
NPI 1063093995 · Ambulatory Care Pharmacist · Wichita, KS
Provider details
- NPI number
- 1063093995
- Entity type
- Individual
- Primary specialty
- Ambulatory Care PharmacistPharmacy Service Providers
- Credential
- PHARMD
- Sex
- Female
- Sole proprietor
- No
- License
- 1-100805 (KS)
Specialties & taxonomies
Pharmacy Service Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
9211 E 21st St N
Wichita, KS 67206-2900
Phone: (316) 609-4501
Street-level locationGet directions
Mailing address
10506 W Hayden St
Wichita, KS 67209-3533
Registry dates
- Enumerated
- 2021-04-21
- Last updated
- 2021-04-21
- Certified
- 2021-04-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.