Individual provider Active NPI

Lindsay J. Garrison

  • Pharmacist
  • Centralia, IL
National Provider Identifier
1275133589
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.292082 Issued in IL
Practice address
1212 W McCord St
Centralia, IL 62801-5648
Phone
(618) 533-1728
Fax
(618) 533-1734
NPI assigned
Oct 27, 2020
Last updated
Oct 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.292082 IL Primary

Addresses

Primary practice location

1212 W McCord St
Centralia, IL 62801-5648

Mailing address

14027 Jem Dr
Aviston, IL 62216-3644
Phone (618) 402-8866

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Ljgarri.s01395.us@wal-mart.com

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

LicenseStateTypeSpecialty
051.292082ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1275133589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14027 JEM DR",
            "city": "AVISTON",
            "state": "IL",
            "postal_code": "622163644",
            "telephone_number": "618-402-8866",
            "fax_number": "618-533-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W MCCORD ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628015648",
            "telephone_number": "618-533-1728",
            "fax_number": "618-533-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "LINDSAY",
        "middle_name": "J.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.292082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ljgarri.s01395.us@wal-mart.com",
            "affiliation": "N",
            "address_1": "1212 W McCord St",
            "city": "Centralia",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628015648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Centralia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.