Active NPI
Kyle Johnson, PHARMD
- Pharmacist
- Harrison, AR
National Provider Identifier
1366042855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD09897
- Practice address
- 161 N Walmart Dr
Harrison, AR 72601-1960 - Phone
- (870) 741-2327
- Fax
- (870) 741-4115
- NPI assigned
- Oct 26, 2020
- 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 | PD09897 | AR | Primary |
Addresses
Primary practice location
161 N Walmart Dr
Harrison, AR 72601-1960
Mailing address
161 N Walmart Dr
Harrison, AR 72601-1960
Phone (870) 741-2327
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126405 | Other | AR | NABP |
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 |
|---|---|---|---|
| PD09897 | AR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1366042855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 N WALMART DR",
"city": "HARRISON",
"state": "AR",
"postal_code": "726011960",
"telephone_number": "870-741-2327",
"fax_number": "870-741-4115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 N WALMART DR",
"city": "HARRISON",
"state": "AR",
"postal_code": "726011960",
"telephone_number": "870-741-2327",
"fax_number": "870-741-4115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KYLE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-26",
"last_updated": "2020-10-26",
"certification_date": "2020-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD09897",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "126405",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harrison, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.