Individual provider Active NPI

Mike J Inmon, RPH

  • Pharmacist
  • Water Valley, MS
National Provider Identifier
1043738875
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E5833 Issued in MS
Practice address
409 Duncan St
Water Valley, MS 38965-2547
Phone
(662) 473-3333
Fax
(662) 473-2921
NPI assigned
Aug 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E5833 MS Primary

Addresses

Primary practice location

409 Duncan St
Water Valley, MS 38965-2547

Mailing address

409 Duncan St
Water Valley, MS 38965-2547
Phone (662) 473-3333

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

LicenseStateTypeSpecialty
E5833MSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Freds Stores of Tennessee Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1043738875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 DUNCAN ST",
            "city": "WATER VALLEY",
            "state": "MS",
            "postal_code": "389652547",
            "telephone_number": "662-473-3333",
            "fax_number": "662-473-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 DUNCAN ST",
            "city": "WATER VALLEY",
            "state": "MS",
            "postal_code": "389652547",
            "telephone_number": "662-473-3333",
            "fax_number": "662-473-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INMON",
        "first_name": "MIKE",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E5833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Water Valley, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; 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.