Active NPI
Terry Wayne Feyen, PD
- Pharmacist
- Magnolia, AR
National Provider Identifier
1336663475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD06709
- Practice address
- 1644 E Main St
Magnolia, AR 71753 - Phone
- (870) 234-3493
- Fax
- (870) 234-5841
- NPI assigned
- Jul 31, 2017
- Last updated
- Jul 21, 2022
- Sex
- Male
- 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 | PD06709 | AR | Primary |
Addresses
Primary practice location
1644 E Main St
Magnolia, AR 71753
Mailing address
1644 E Main St
Magnolia, AR 71753-3804
Phone (870) 234-3493
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 |
|---|---|---|---|
| PD06709 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1644 E Main St
Magnolia, AR 71753
Phone (870) 234-3493
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1336663475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1644 E MAIN ST",
"city": "MAGNOLIA",
"state": "AR",
"postal_code": "717533804",
"telephone_number": "870-234-3493",
"fax_number": "870-234-5841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1644 E MAIN ST",
"city": "MAGNOLIA",
"state": "AR",
"postal_code": "71753",
"telephone_number": "870-234-3493",
"fax_number": "870-234-5841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEYEN",
"first_name": "TERRY",
"middle_name": "WAYNE",
"credential": "PD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-31",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD06709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Magnolia, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.