Domonique Deshea Wadley, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD15023 Issued in AR

Practice address

998 Shady Grove Rd Ste 1H
Hot Springs, AR 71901-8094

Phone

(501) 262-5400

Fax

(501) 262-5404

NPI assigned

Jul 9, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lakeside Pharmacy Inc.

  • Community/Retail Pharmacy
  • Hot Springs, AR
  • NPI 1801185574
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1023636610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 LACROSSE ST",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719139553",
            "telephone_number": "501-655-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 SHADY GROVE RD STE 1H",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719018094",
            "telephone_number": "501-262-5400",
            "fax_number": "501-262-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADLEY",
        "first_name": "DOMONIQUE",
        "middle_name": "DESHEA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD15023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• VRM Medical, , LLC
• Doris Ann Wacaster, RNC
• Lillie Wacaster, LAC
• Priscilla Alice Wacaster, M.D.
• Billy Kossuth Wade, MD
• Misti Wagley, LPN
• Wagnon Physical Therapy LLC
• Jason Wagnon, PT, DPT
• Mian Adnan Waheed, M.D.
• Wal-Mart Stores, Inc.

• Pharmacist in Hot Springs, AR
• Providers in Hot Springs, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.