Active NPI
Bobby Tai Le
- Pharmacist
- Maumelle, AR
National Provider Identifier
1215660675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD16217
- Practice address
- 115 Commons Dr
Maumelle, AR 72113-7266 - Phone
- (501) 803-3274
- NPI assigned
- Jul 5, 2022
- Last updated
- Jul 5, 2022
- Sex
- Male
- 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 | PD16217 | AR | Primary |
Addresses
Primary practice location
115 Commons Dr
Maumelle, AR 72113-7266
Mailing address
16 Deerwood Dr
Conway, AR 72034-6113
Phone (870) 834-6193
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 |
|---|---|---|---|
| PD16217 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
115 Commons Dr
Maumelle, AR 72113
Phone (501) 803-3274
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": "1656979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656979200000",
"number": "1215660675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 DEERWOOD DR",
"city": "CONWAY",
"state": "AR",
"postal_code": "720346113",
"telephone_number": "870-834-6193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 COMMONS DR",
"city": "MAUMELLE",
"state": "AR",
"postal_code": "721137266",
"telephone_number": "501-803-3274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LE",
"first_name": "BOBBY",
"middle_name": "TAI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-05",
"last_updated": "2022-07-05",
"certification_date": "2022-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD16217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maumelle, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.