Individual provider Active NPI

Jack Lin

  • Pharmacist
  • Little Rock, AR
National Provider Identifier
1295166361
Registry record updated Nov 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD12508 Issued in AR
Practice address
44 Commentry Dr
Little Rock, AR 72223-4595
Phone
(501) 681-5885
NPI assigned
Nov 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD12508 AR Primary

Addresses

Primary practice location

44 Commentry Dr
Little Rock, AR 72223-4595

Mailing address

44 Commentry Dr
Little Rock, AR 72223-4595

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
PD12508ARMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385510400000",
    "number": "1295166361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 COMMENTRY DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 COMMENTRY DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234595",
            "telephone_number": "501-681-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "JACK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-27",
        "last_updated": "2013-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD12508",
            "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 Nov 27, 2013; 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.