Active NPI
Jennifer Lanelle Wynn, PHARMD
- Pharmacist
- Newport, AR
National Provider Identifier
1285222307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD05380
- Practice address
- 1303 McLain St
Newport, AR 72112-3633 - Phone
- (870) 523-5888
- Fax
- (870) 523-9980
- NPI assigned
- Jan 5, 2021
- Sex
- Female
- Sole proprietor
- No
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 | PD05380 | AR | Primary |
Addresses
Primary practice location
1303 McLain St
Newport, AR 72112-3633
Mailing address
3400 Ridgeway Cir
Jonesboro, AR 72404-5004
Phone (870) 351-2942
Other practice location 1
2895 State Highway 77 S Ste 1
Marion, AR 72364-2371
Phone (870) 739-1700
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
| License | State | Type | Specialty |
|---|---|---|---|
| PD05380 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jimmie N Darling P a Inc | Current | Accepting new patients | |
| Jimmie N Darling P a Inc | Past | Accepting new patients |
Locations
1303 McLain St
Newport, AR 72112
Phone (870) 523-5888
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": "1609804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609804800000",
"number": "1285222307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 RIDGEWAY CIR",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724045004",
"telephone_number": "870-351-2942",
"fax_number": "870-739-1702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1303 MCLAIN ST",
"city": "NEWPORT",
"state": "AR",
"postal_code": "721123633",
"telephone_number": "870-523-5888",
"fax_number": "870-523-9980"
}
],
"practiceLocations": [
{
"address_1": "2895 State Highway 77 S Ste 1",
"address_purpose": "LOCATION",
"city": "Marion",
"state": "AR",
"postal_code": "723642371",
"country_code": "US",
"telephone_number": "870-739-1700",
"fax_number": "870-739-1702",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WYNN",
"first_name": "JENNIFER",
"middle_name": "LANELLE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-05",
"last_updated": "2021-01-05",
"certification_date": "2021-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD05380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.