Individual provider Active NPI

Larry Jack New Jr.

  • Pharmacist
  • Williamson, WV
National Provider Identifier
1093060568
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
013899 Issued in KY
Practice address
210 Logan St
Williamson, WV 25661-3608
Phone
(304) 235-3535
NPI assigned
Jul 19, 2012
Last updated
Jul 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 013899 KY Primary

Addresses

Primary practice location

210 Logan St
Williamson, WV 25661-3608

Mailing address

2596 Forest Hills Rd
Forest Hills, KY 41527-8404
Phone (606) 237-7539

Other names 1

  • Larry Jack New Other name

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
013899KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1093060568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2596 FOREST HILLS RD",
            "city": "FOREST HILLS",
            "state": "KY",
            "postal_code": "415278404",
            "telephone_number": "606-237-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LOGAN ST",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613608",
            "telephone_number": "304-235-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEW",
        "first_name": "LARRY",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "013899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARRY",
            "last_name": "NEW",
            "middle_name": "JACK",
            "credential": "PHARMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Williamson, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.