Active NPI
Mary Katherine McLemore, D.PH.
- Pharmacist
- Anadarko, OK
National Provider Identifier
1174129035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11334
- Practice address
- 1201 West Petree
Walmart Pharmacy
Anadarko, OK 73005 - Phone
- (405) 247-2404
- NPI assigned
- Dec 7, 2020
- Last updated
- Dec 7, 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 | 11334 | OK | Primary |
Addresses
Primary practice location
1201 West Petree
Walmart Pharmacy
Anadarko, OK 73005
Mailing address
28780 15TH St SW
Hinton, OK 73047-2005
Phone (405) 542-7895
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11334 | Other | OK | OKLAHOMA STATE BOARD OF PHARMACY |
Other names 1
- Dr. Mary Katherine Humphreys
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 |
|---|---|---|---|
| 11334 | OK | 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 10-0162
- Community/Retail Pharmacy
- Anadarko, OK
- NPI 1225055346
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607299200000",
"number": "1174129035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28780 15TH ST SW",
"city": "HINTON",
"state": "OK",
"postal_code": "730472005",
"telephone_number": "405-542-7895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 WEST PETREE",
"address_2": "WALMART PHARMACY",
"city": "ANADARKO",
"state": "OK",
"postal_code": "73005",
"telephone_number": "405-247-2404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLEMORE",
"first_name": "MARY",
"middle_name": "KATHERINE",
"name_prefix": "Mrs.",
"credential": "D.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-07",
"last_updated": "2020-12-07",
"certification_date": "2020-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "11334",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OKLAHOMA STATE BOARD OF PHARMACY",
"identifier": "11334",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "HUMPHREYS",
"middle_name": "KATHERINE",
"prefix": "DR.",
"credential": "D.PH.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Anadarko, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.