Active NPI
Tim Wood, RPH
- Pharmacist
- Macon, MO
National Provider Identifier
1467930099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 044438
- Practice address
- 705 E Briggs Dr
Macon, MO 63552-1906 - Phone
- (660) 385-5794
- NPI assigned
- Aug 6, 2018
- Last updated
- Aug 6, 2018
- Sex
- Male
- Sole proprietor
- No
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 | 044438 | MO | Primary |
Addresses
Primary practice location
705 E Briggs Dr
Macon, MO 63552-1906
Mailing address
23336 Monroe Road 1131
Madison, MO 65263-2037
Phone (660) 651-3541
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 |
|---|---|---|---|
| 044438 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Past | Accepting new patients | |
| Wal-Mart Stores East, LP | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Walmart Pharmacy 10-0783
- Community/Retail Pharmacy
- Macon, MO
- NPI 1316964638
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533513600000",
"number": "1467930099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23336 MONROE ROAD 1131",
"city": "MADISON",
"state": "MO",
"postal_code": "652632037",
"telephone_number": "660-651-3541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 E BRIGGS DR",
"city": "MACON",
"state": "MO",
"postal_code": "635521906",
"telephone_number": "660-385-5794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "TIM",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-06",
"last_updated": "2018-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "044438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.