Denice Gordy, PHARMACIST

Primary specialty

PharmacistTaxonomy code 183500000X

License

016016 Issued in LA

Practice address

3670 W Oak St
Jena, LA 71342-4474

Phone

(318) 992-1357

Fax

(318) 992-1359

NPI assigned

Jul 18, 2018

Last updated

Jul 18, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dewanna Denice Gordy Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wal-Mart Stores East LP

  dba Walmart Pharmacy 10-0498

  • Community/Retail Pharmacy
  • Jena, LA
  • NPI 1346267614
  NPD (past)
• Wal-Mart Stores East, LP

  dba Walmart Pharmacy 10-2229

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1346726692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1647 HIGHWAY 124 E",
            "city": "KELLY",
            "state": "LA",
            "postal_code": "714412028",
            "telephone_number": "318-495-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 W OAK ST",
            "city": "JENA",
            "state": "LA",
            "postal_code": "713424474",
            "telephone_number": "318-992-1357",
            "fax_number": "318-992-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDY",
        "first_name": "DENICE",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "016016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1346267614",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEWANNA",
            "last_name": "GORDY",
            "middle_name": "DENICE",
            "credential": "PHARMACIST",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rachel Gaddis Floyd, DDS
• Linda Ford, FNP-BC
• Bradley Scott Foster, PT
• Cecil Clyde Gaddis, DDS
• Golden Age Nursing Center, LLC
• Lauren Paige Grant, SLP
• Traci Gray, AGNP-C
• Elizabeth Elois Greene, LCSW
• Pamela Ruth Hamilton
• Kristal Hardie, OTR/L

• Pharmacist in Jena, LA
• Providers in Jena, LA by specialty
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.