Active NPI
Ryan Higgs
- Pharmacist
- Russellville, AR
National Provider Identifier
1154922565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD12308
- Practice address
- 2409 E Main St
Russellville, AR 72802-9619 - Phone
- (479) 968-2970
- NPI assigned
- Nov 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | PD12308 | AR | Primary |
Addresses
Primary practice location
2409 E Main St
Russellville, AR 72802-9619
Mailing address
215 Lloyd LN
London, AR 72847-7007
Other names 1
- Ryan Brent
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 |
|---|---|---|---|
| PD12308 | AR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604361600000",
"number": "1154922565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 LLOYD LN",
"city": "LONDON",
"state": "AR",
"postal_code": "728477007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2409 E MAIN ST",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728029619",
"telephone_number": "479-968-2970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIGGS",
"first_name": "RYAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-03",
"last_updated": "2020-11-03",
"certification_date": "2020-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD12308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RYAN",
"last_name": "BRENT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Russellville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.