Active NPI
Patricia Wong Wolf, RPH
- Pharmacist
- Cleveland, MS
National Provider Identifier
1003832247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-5726
- Practice address
- 810 E Sunflower Rd
Suite 100-D
Cleveland, MS 38732-2800 - Phone
- (662) 843-4214
- NPI assigned
- Jul 14, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 | E-5726 | MS | Primary |
Addresses
Primary practice location
810 E Sunflower Rd
Suite 100-D
Cleveland, MS 38732-2800
Mailing address
810 E Sunflower Rd
Suite 100-D
Cleveland, MS 38732-2800
Phone (662) 843-4214
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00030115 | Medicaid | MS | |
| 2513592 | Other | NABP |
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 |
|---|---|---|---|
| E-5726 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cleveland Medical Arts Pharmacy Inc | Past | Accepting new patients | |
| Cleveland Medical Arts Pharmacy Inc | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/10381/brand/1/csg/1/fhir/r4
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Cleveland Medical Arts Pharmacy LTC
- Long Term Care Pharmacy
- Cleveland, MS
- NPI 1508613688
-
- Community/Retail Pharmacy
- Cleveland, MS
- NPI 1730121336
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003832247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 E SUNFLOWER RD",
"address_2": "SUITE 100-D",
"city": "CLEVELAND",
"state": "MS",
"postal_code": "387322800",
"telephone_number": "662-843-4214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 E SUNFLOWER RD",
"address_2": "SUITE 100-D",
"city": "CLEVELAND",
"state": "MS",
"postal_code": "387322800",
"telephone_number": "662-843-4214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLF",
"first_name": "PATRICIA",
"middle_name": "WONG",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-5726",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00030115",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "2513592",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, MS
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.