Individual provider Active NPI

Marty Dilworth, RPH

  • Pharmacist
  • Corinth, MS
National Provider Identifier
1255816351
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
T-08992 Issued in MS
Practice address
111 Alcorn Dr
Corinth, MS 38834-9359
Phone
(662) 284-5459
Fax
(662) 287-6280
NPI assigned
Sep 25, 2018
Last updated
Sep 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X T-08992 MS Primary

Addresses

Primary practice location

111 Alcorn Dr
Corinth, MS 38834-9359

Mailing address

111 Alcorn Dr
Corinth, MS 38834-9359
Phone (662) 284-5459

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
T-08992MSMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1255816351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349359",
            "telephone_number": "662-284-5459",
            "fax_number": "662-287-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349359",
            "telephone_number": "662-284-5459",
            "fax_number": "662-287-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILWORTH",
        "first_name": "MARTY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "T-08992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.