Individual provider Active NPI

Charles Carnation III

  • Pharmacist
  • Fort Smith, AR
National Provider Identifier
1184036477
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD07240 Issued in AR
Practice address
2701 Rogers Ave
Fort Smith, AR 72901-4225
Phone
(479) 783-4782
Fax
(479) 783-7092
NPI assigned
May 21, 2014
Last updated
May 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD07240 AR Primary

Addresses

Primary practice location

2701 Rogers Ave
Fort Smith, AR 72901-4225

Mailing address

2701 Rogers Ave
Fort Smith, AR 72901-4225
Phone (479) 783-4782

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

LicenseStateTypeSpecialty
PD07240ARMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co 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.

NPI Registry JSON

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1184036477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014225",
            "telephone_number": "479-783-4782",
            "fax_number": "479-783-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014225",
            "telephone_number": "479-783-4782",
            "fax_number": "479-783-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNATION",
        "first_name": "CHARLES",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-21",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD07240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.