Active NPI
Lauren Mackenzie Bellamy
- Pharmacist
- Fayetteville, AR
National Provider Identifier
1215772454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD17014
- Practice address
- 3475 Black Forest Dr
Fayetteville, AR 72704-6524 - Phone
- (479) 442-2276
- NPI assigned
- Jun 28, 2024
- Last updated
- Jun 28, 2024
- 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 | PD17014 | AR | Primary |
Addresses
Primary practice location
3475 Black Forest Dr
Fayetteville, AR 72704-6524
Mailing address
180 Towne Park Rd Unit D
Tontitown, AR 72762-1411
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 |
|---|---|---|---|
| PD17014 | AR | 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, 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": "1719532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719532800000",
"number": "1215772454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 TOWNE PARK RD UNIT D",
"city": "TONTITOWN",
"state": "AR",
"postal_code": "727621411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3475 BLACK FOREST DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727046524",
"telephone_number": "479-442-2276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLAMY",
"first_name": "LAUREN",
"middle_name": "MACKENZIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-28",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD17014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.