Individual provider Active NPI

Mary Abigayle Merry

  • Pharmacist
  • North Little Rock, AR
National Provider Identifier
1366047391
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD13241 Issued in AR
Practice address
2501 McCain Blvd
North Little Rock, AR 72116-7606
Phone
(501) 404-6059
NPI assigned
Nov 30, 2020
Last updated
Nov 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD13241 AR Primary

Addresses

Primary practice location

2501 McCain Blvd
North Little Rock, AR 72116-7606

Mailing address

2501 McCain Blvd
North Little Rock, AR 72116-7606

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

LicenseStateTypeSpecialty
PD13241ARMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas CVS Pharmacy LLC PastSince Dec 6, 2020 Accepting new patients

Organizations & group practices 1

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": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1366047391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 MCCAIN BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 MCCAIN BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167606",
            "telephone_number": "501-404-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRY",
        "first_name": "MARY",
        "middle_name": "ABIGAYLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD13241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.

Verify at the official NPI Registry.