Nikki R Walters

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0013001.1 Issued in MS

Legal business name

NIKKI R WALTERS

Practice address

122 S Front St
Ellisville, MS 39437-3118

Phone

(601) 477-8587

Fax

(601) 477-3222

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Nikki Red WaltersNPI 1669636023

Title

Owner

Phone

(601) 477-8587

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• WARD'S PHARMACY Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nikki Red Walters

  • Pharmacist
  • Ellisville, MS
  • NPI 1669636023
  NPD (past) Authorized official
• Clarence Lee Middleton, RPH

  • Pharmacy
  • Ellisville, MS
  • NPI 1043749070
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1316046402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S FRONT ST",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394373118",
            "telephone_number": "601-477-8587",
            "fax_number": "601-477-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S FRONT ST",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394373118",
            "telephone_number": "601-477-8587",
            "fax_number": "601-477-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIKKI R WALTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_middle_name": "RED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-477-8587",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-03592",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "0013001.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00330679",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WARD'S PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alecia A Moore, DMD
• Joseph Rodney Moring, M.D.
• MW Staffing
• Fiso Ncube
• Edie Nicholson, PCMHT
• Tammy Nobles
• Wanda Parker, CCSS
• Paul D. Cotten
• Pecan Grove
• Hope Perkins, DO

• Community/Retail Pharmacy in Ellisville, MS
• Providers in Ellisville, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.