Individual provider Active NPI

John Alan Vinson, PHARM.D.

  • Pharmacist
  • Little Rock, AR
National Provider Identifier
1316050495
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD09847 Issued in AR
Practice address
417 S Victory St
Little Rock, AR 72201-2932
Phone
(501) 372-5250
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 09847 AR
Pharmacist 183500000X PD09847 AR Primary

Addresses

Primary practice location

417 S Victory St
Little Rock, AR 72201-2932

Mailing address

7403 Worth Ave E
Benton, AR 72019-6886
Phone (479) 462-9640

Other practice location 1

612 S 12th St
Fort Smith, AR 72901-4702
Phone (479) 424-3166

Other identifiers 1

IdentifierTypeStateIssuer
09847OtherARPHARMACIST LICENSE NUMBER

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

LicenseStateTypeSpecialty
09847ARMDPharmacist
PD09847ARMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1316050495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7403 WORTH AVE E",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720196886",
            "telephone_number": "479-462-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 S VICTORY ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722012932",
            "telephone_number": "501-372-5250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 S 12th St",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "729014702",
            "country_code": "US",
            "telephone_number": "479-424-3166",
            "fax_number": "479-785-0732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINSON",
        "first_name": "JOHN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "09847",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD09847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "09847",
            "state": "AR"
        }
    ],
    "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 Sep 9, 2022; 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.