Active NPI
Beth Annette Bagwell, PHARM.D., CGP
- Pharmacist
- Pampa, TX
National Provider Identifier
1417954157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20987
- Practice address
- 1420 N Hobart St
Pampa, TX 79065-4124 - Phone
- (806) 665-7642
- Fax
- (806) 665-7226
- NPI assigned
- Jul 7, 2005
- 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 | 20987 | TX | Primary |
Addresses
Primary practice location
1420 N Hobart St
Pampa, TX 79065-4124
Mailing address
2301 Beech LN
Pampa, TX 79065-3024
Phone (806) 688-0148
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 |
|---|---|---|---|
| 20987 | TX | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Supermarkets LLC | Past | Accepting new patients | |
| United Supermarkets LLC | 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.
-
- Community/Retail Pharmacy
- Pampa, TX
- NPI 1639156524
-
- Community/Retail Pharmacy
- Rio Rancho, NM
- NPI 1346061900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267574400000",
"number": "1417954157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 BEECH LN",
"city": "PAMPA",
"state": "TX",
"postal_code": "790653024",
"telephone_number": "806-688-0148",
"fax_number": "806-665-7226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 N HOBART ST",
"city": "PAMPA",
"state": "TX",
"postal_code": "790654124",
"telephone_number": "806-665-7642",
"fax_number": "806-665-7226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGWELL",
"first_name": "BETH",
"middle_name": "ANNETTE",
"name_prefix": "Dr.",
"credential": "PHARM.D., CGP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-07",
"last_updated": "2010-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "20987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pampa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.