Individual provider Active NPI

Morgan Nicole Gillum, PHARMD

  • Pharmacist
  • Little Rock, AR
National Provider Identifier
1235701806
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD15776 Issued in AR
Practice address
1900 N Polk St
Little Rock, AR 72207-4634
Phone
(501) 663-3257
NPI assigned
Jul 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD15776 AR Primary

Addresses

Primary practice location

1900 N Polk St
Little Rock, AR 72207-4634

Mailing address

1900 N Polk St
Little Rock, AR 72207-4634
Phone (501) 663-3257

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

LicenseStateTypeSpecialty
PD15776ARMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I PastSince Jul 25, 2021 Accepting new patients
Kroger Limited Partnership I PastSince Jul 25, 2021 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": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1235701806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 N POLK ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722074634",
            "telephone_number": "501-663-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N POLK ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722074634",
            "telephone_number": "501-663-3257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLUM",
        "first_name": "MORGAN",
        "middle_name": "NICOLE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD15776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.