Individual provider Active NPI

Brent Allen Powell

  • Pharmacist
  • Jonesboro, AR
National Provider Identifier
1053047290
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD16249 Issued in AR
Practice address
1815 E Highland Dr
Jonesboro, AR 72401-6118
Phone
(870) 972-1838
NPI assigned
Jul 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD16249 AR Primary

Addresses

Primary practice location

1815 E Highland Dr
Jonesboro, AR 72401-6118

Mailing address

1501 Hemingway Cir
Jonesboro, AR 72405-5572
Phone (601) 248-6588

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

State licenses

LicenseStateTypeSpecialty
PD16249ARMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1053047290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HEMINGWAY CIR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724055572",
            "telephone_number": "601-248-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 E HIGHLAND DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016118",
            "telephone_number": "870-972-1838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "BRENT",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD16249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.