Individual provider Active NPI

Olivia Brooks Wingate, PHARMD

  • Pharmacist
  • Memphis, TN
National Provider Identifier
1356983308
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
43415 Issued in TN
Practice address
8700 W Trail Lake Dr Ste 205
Memphis, TN 38125-8205
Phone
(901) 309-1404
NPI assigned
Oct 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 43415 TN Primary

Addresses

Primary practice location

8700 W Trail Lake Dr Ste 205
Memphis, TN 38125-8205

Mailing address

2553 Strathspey CV
Memphis, TN 38119-7718
Phone (901) 482-4463

Other practice location 1

5148 Highway 51 N
Senatobia, MS 38668-1720
Phone (662) 562-9366

Other practice location 2

5121 Quince Rd
Memphis, TN 38117-6846
Phone (901) 682-2136

Other practice location 3

950 E Commerce St
Hernando, MS 38632-2433
Phone (662) 429-3349

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
43415TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Mar 13, 2022 Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Apr 3, 2022 Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1356983308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2553 STRATHSPEY CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381197718",
            "telephone_number": "901-482-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 W TRAIL LAKE DR STE 205",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258205",
            "telephone_number": "901-309-1404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5148 Highway 51 N",
            "address_purpose": "LOCATION",
            "city": "Senatobia",
            "state": "MS",
            "postal_code": "386681720",
            "country_code": "US",
            "telephone_number": "662-562-9366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5121 Quince Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381176846",
            "country_code": "US",
            "telephone_number": "901-682-2136",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "950 E Commerce St",
            "address_purpose": "LOCATION",
            "city": "Hernando",
            "state": "MS",
            "postal_code": "386322433",
            "country_code": "US",
            "telephone_number": "662-429-3349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINGATE",
        "first_name": "OLIVIA",
        "middle_name": "BROOKS",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "43415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.