Organization Active NPI

Ivy Family Pharmacy, Inc

  • Community/Retail Pharmacy
  • Heber Springs, AR
National Provider Identifier
1093118945
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR07038 Issued in AR
Legal business name
IVY FAMILY PHARMACY, INC
Doing business as
Family Disco Pharmacy
Practice address
120 S 4TH St
Heber Springs, AR 72543-3810
Phone
(501) 362-5853
Fax
(501) 362-5854
NPI assigned
Oct 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Authorized official

Name
Dr. Jamie Carol IvyNPI 1740879931
Title
Pharmacist
Phone
(501) 206-7301

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X AR07038 AR Primary

Addresses

Primary practice location

120 S 4TH St
Heber Springs, AR 72543-3810

Mailing address

120 S 4TH St
Heber Springs, AR 72543-3810
Phone (501) 362-5853

Other identifiers 1

IdentifierTypeStateIssuer
2148245OtherPK

Other names 1

  • Family Disco Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141224000659 AR Part B Supplier - Mass Immunization (Roster Biller Only) 4688997687 Practice locations: Heber Springs, AR

National Provider Directory

National Provider Directory

Locations

120 S 4th St
Heber Springs, AR 72543
Phone (501) 362-5853

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1093118945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S 4TH ST",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725433810",
            "telephone_number": "501-362-5853",
            "fax_number": "501-362-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S 4TH ST",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725433810",
            "telephone_number": "501-362-5853",
            "fax_number": "501-362-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY FAMILY PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-07",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A",
        "authorized_official_last_name": "IVY",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "501-206-7301",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR07038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148245",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Disco Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Heber Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.