Active NPI
John Barrett Martindale, PHARM.D.
- Pharmacist
- Horn Lake, MS
National Provider Identifier
1386913523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- T-09877
- Practice address
- 1501 Goodman Rd W
Horn Lake, MS 38637-1400 - Phone
- (662) 342-9283
- Fax
- (662) 342-9289
- NPI assigned
- Dec 16, 2011
- Last updated
- Dec 16, 2011
- Sex
- Male
- 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 | T-09877 | MS | Primary |
Addresses
Primary practice location
1501 Goodman Rd W
Horn Lake, MS 38637-1400
Mailing address
4044 Upper Valley CV
Olive Branch, MS 38654-6095
Phone (901) 826-7613
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00330158 | Medicaid | MS |
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 |
|---|---|---|---|
| T-09877 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323993600000",
"number": "1386913523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4044 UPPER VALLEY CV",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "386546095",
"telephone_number": "901-826-7613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 GOODMAN RD W",
"city": "HORN LAKE",
"state": "MS",
"postal_code": "386371400",
"telephone_number": "662-342-9283",
"fax_number": "662-342-9289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINDALE",
"first_name": "JOHN",
"middle_name": "BARRETT",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-16",
"last_updated": "2011-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "T-09877",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00330158",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Horn Lake, MS
- Terrance Franklin Long, RPH
- Loved Ones Home Care LLC
- Lsa Pediatric Therapy
- Jessica Lucovich, DDS
- Adam C Marshall, PTA
- Justin Mathis, PHARM.D
- William P McAlexander, DMD
- McKenzie Alexandra McClanahan, DPT
- Memphis Emergency Specialists PC (Southern Family Medical Clinic)
- Mid South Chiropractic of Horn Lake PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.