Active NPI
Oktawia Amadea Deyoung, PHARMD
- Pharmacist
- Little Rock, AR
National Provider Identifier
1366038507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD15008
- Practice address
- 4301 W Markham St
Little Rock, AR 72205-7101 - Phone
- (501) 526-4838
- NPI assigned
- Dec 11, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | PD15008 | AR | Primary |
Addresses
Primary practice location
4301 W Markham St
Little Rock, AR 72205-7101
Mailing address
2400 Riverfront Dr Apt 444
Little Rock, AR 72202-2220
Phone (501) 467-0410
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
| License | State | Type | Specialty |
|---|---|---|---|
| PD15008 | AR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607644800000",
"number": "1366038507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 RIVERFRONT DR APT 444",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722022220",
"telephone_number": "501-467-0410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 W MARKHAM ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722057101",
"telephone_number": "501-526-4838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEYOUNG",
"first_name": "OKTAWIA",
"middle_name": "AMADEA",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-11",
"last_updated": "2020-12-11",
"certification_date": "2020-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD15008",
"primary": true
}
],
"identifiers": [],
"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 Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.