Active NPI
Taylor Matthew Knight
- Pharmacist
- Bentonville, AR
National Provider Identifier
1407458086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD12132
- Practice address
- 1703 E Central Ave
Bentonville, AR 72712-5523 - Phone
- (479) 418-0229
- NPI assigned
- Nov 10, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2012025414 | MO | |
| Pharmacist | 183500000X | PD12132 | AR | Primary |
Addresses
Primary practice location
1703 E Central Ave
Bentonville, AR 72712-5523
Mailing address
1502 Fontaine CT
Centerton, AR 72719-8808
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
| License | State | Type | Specialty |
|---|---|---|---|
| PD12132 | AR | MD | Pharmacist |
| 2012025414 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604966400000",
"number": "1407458086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1502 FONTAINE CT",
"city": "CENTERTON",
"state": "AR",
"postal_code": "727198808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1703 E CENTRAL AVE",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727125523",
"telephone_number": "479-418-0229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNIGHT",
"first_name": "TAYLOR",
"middle_name": "MATTHEW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-10",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2012025414",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD12132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.