Individual provider Active NPI

Johnene West Thames, RPH

  • Pharmacist
  • Wiggins, MS
National Provider Identifier
1134438997
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E6607 Issued in MS
Practice address
116 Second St S
Wiggins, MS 39577-2758
Phone
(601) 928-3215
Fax
(601) 928-6072
NPI assigned
Sep 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E6607 MS Primary

Addresses

Primary practice location

116 Second St S
Wiggins, MS 39577-2758

Mailing address

116 Second St S
Wiggins, MS 39577-2758
Phone (601) 928-3215

Other identifiers 1

IdentifierTypeStateIssuer
E6607OtherMSPHARMACIST LICENSE

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
E6607MSMDPharmacist

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": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1134438997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 SECOND ST S",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395772758",
            "telephone_number": "601-928-3215",
            "fax_number": "601-928-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 SECOND ST S",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395772758",
            "telephone_number": "601-928-3215",
            "fax_number": "601-928-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAMES",
        "first_name": "JOHNENE",
        "middle_name": "WEST",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E6607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "E6607",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wiggins, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; 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.