Active NPI
Alan Butler
- Pharmacist
- Ava, MO
National Provider Identifier
1134526627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH045121
- Practice address
- 124 W Washington Ave
Ava, MO 65608-6504 - Phone
- (417) 683-4127
- Fax
- (417) 683-6160
- NPI assigned
- Nov 26, 2014
- Last updated
- Jan 18, 2023
- Sex
- Male
- 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 | PH045121 | MO | Primary |
Addresses
Primary practice location
124 W Washington Ave
Ava, MO 65608-6504
Mailing address
124 W Washington Ave
Ava, MO 65608-6504
Phone (417) 683-4127
Other practice location 1
2050 W State Highway 76
Branson, MO 65616-2100
Phone (417) 334-7181
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH045121 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients | |
| Wal-Mart Stores East LP | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Walmart Pharmacy 10-0032
- Community/Retail Pharmacy
- Branson, MO
- NPI 1598782815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674000000000",
"number": "1134526627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 W WASHINGTON AVE",
"city": "AVA",
"state": "MO",
"postal_code": "656086504",
"telephone_number": "417-683-4127",
"fax_number": "417-683-6160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 W WASHINGTON AVE",
"city": "AVA",
"state": "MO",
"postal_code": "656086504",
"telephone_number": "417-683-4127",
"fax_number": "417-683-6160"
}
],
"practiceLocations": [
{
"address_1": "2050 W State Highway 76",
"address_purpose": "LOCATION",
"city": "Branson",
"state": "MO",
"postal_code": "656162100",
"country_code": "US",
"telephone_number": "417-334-7181",
"fax_number": "417-334-7181",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUTLER",
"first_name": "ALAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-26",
"last_updated": "2023-01-18",
"certification_date": "2023-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "PH045121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ava, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.