Active NPI
Sandra N Wade, PHARM.D
- Pharmacist
- Jonesboro, AR
National Provider Identifier
1194313965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD14114
- Practice address
- 3319 Harrisburg Rd
Jonesboro, AR 72404-8782 - Phone
- (870) 203-7087
- Fax
- (870) 203-7088
- NPI assigned
- Jan 6, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2017025932 | MO | |
| Pharmacist | 183500000X | PD14114 | AR | Primary |
Addresses
Primary practice location
3319 Harrisburg Rd
Jonesboro, AR 72404-8782
Mailing address
3319 Harrisburg Rd
Jonesboro, AR 72404-8782
Phone (870) 203-7087
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD14114 | AR | MD | Pharmacist |
| 2017025932 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609891200000",
"number": "1194313965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3319 HARRISBURG RD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724048782",
"telephone_number": "870-203-7087",
"fax_number": "870-203-7088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3319 HARRISBURG RD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724048782",
"telephone_number": "870-203-7087",
"fax_number": "870-203-7088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "SANDRA",
"middle_name": "N",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-06",
"last_updated": "2021-01-06",
"certification_date": "2021-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2017025932",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD14114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.