Active NPI
Alyssa Charlton
- Pharmacist
- Springdale, AR
National Provider Identifier
1306446323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD13093
- Practice address
- 1517 Gene George Blvd
Springdale, AR 72762-0716 - Phone
- (479) 365-8134
- Fax
- (479) 365-8133
- NPI assigned
- Oct 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2013022789 | MO | |
| Pharmacist | 183500000X | PD13093 | AR | Primary |
Addresses
Primary practice location
1517 Gene George Blvd
Springdale, AR 72762-0716
Mailing address
6200 W Tumbler RDG
Rogers, AR 72758-4035
Phone (479) 366-2621
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
| License | State | Type | Specialty |
|---|---|---|---|
| PD13093 | AR | MD | Pharmacist |
| 2013022789 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1306446323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6200 W TUMBLER RDG",
"city": "ROGERS",
"state": "AR",
"postal_code": "727584035",
"telephone_number": "479-366-2621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1517 GENE GEORGE BLVD",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727620716",
"telephone_number": "479-365-8134",
"fax_number": "479-365-8133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLTON",
"first_name": "ALYSSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-28",
"last_updated": "2020-10-28",
"certification_date": "2020-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2013022789",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD13093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.