Active NPI
Cheryll Angel Ray, RPH
- Pharmacist
- Vardaman, MS
National Provider Identifier
1083131882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-08809
- Practice address
- 101 W Sweet Potato St
Vardaman, MS 38878-9433 - Phone
- (833) 773-1885
- Fax
- (888) 804-2104
- NPI assigned
- Aug 23, 2017
- Sex
- Female
- Sole proprietor
- No
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-08809 | MS | Primary |
Addresses
Primary practice location
101 W Sweet Potato St
Vardaman, MS 38878-9433
Mailing address
127 Peyton Cir
Oxford, MS 38655-8171
Phone (662) 234-0584
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-08809 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New 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.
-
dba Freds Pharmacy 3648
- Community/Retail Pharmacy
- Greenville, MS
- NPI 1093969016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661385600000",
"number": "1083131882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 PEYTON CIR",
"city": "OXFORD",
"state": "MS",
"postal_code": "386558171",
"telephone_number": "662-234-0584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W SWEET POTATO ST",
"city": "VARDAMAN",
"state": "MS",
"postal_code": "388789433",
"telephone_number": "833-773-1885",
"fax_number": "888-804-2104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAY",
"first_name": "CHERYLL",
"middle_name": "ANGEL",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-23",
"last_updated": "2022-08-25",
"certification_date": "2022-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-08809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vardaman, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.