Active NPI
Penny Knight Dickens, RPH
- Pharmacist
- Shreveport, LA
National Provider Identifier
1376556472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14173
- Practice address
- 510 E Stoner Ave
Shreveport, LA 71101-4243 - Phone
- (318) 221-8411
- NPI assigned
- Aug 14, 2006
- 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 | 14173 | LA | Primary |
Addresses
Primary practice location
510 E Stoner Ave
Shreveport, LA 71101-4243
Mailing address
2452 Churchill Dr
Bossier City, LA 71111-5558
Phone (318) 464-9656
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14173 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376556472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2452 CHURCHILL DR",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711115558",
"telephone_number": "318-464-9656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 E STONER AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711014243",
"telephone_number": "318-221-8411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKENS",
"first_name": "PENNY",
"middle_name": "KNIGHT",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "14173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.