Active NPI
Timothy Phillip Talon Burnside, PHARM.D.
- Pharmacist
- Conway, AR
National Provider Identifier
1497277859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD14051
- Practice address
- 1120 E German LN
Conway, AR 72032-4555 - Phone
- (501) 329-3733
- NPI assigned
- Jul 7, 2017
- 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 | PD14051 | AR | Primary |
Addresses
Primary practice location
1120 E German LN
Conway, AR 72032-4555
Mailing address
5618 B St Apt 4
Little Rock, AR 72205-3369
Phone (479) 221-2476
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PD14051 | Other | AR | PHARMACIST LICENSE |
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 |
|---|---|---|---|
| PD14051 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harps Food Stores, Inc | Past | Accepting new patients | |
| Harps Food Stores, 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.
-
- Community/Retail Pharmacy
- Springdale, AR
- NPI 1235239559
-
- Community/Retail Pharmacy
- Conway, AR
- NPI 1881909638
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499385600000",
"number": "1497277859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5618 B ST APT 4",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722053369",
"telephone_number": "479-221-2476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 E GERMAN LN",
"city": "CONWAY",
"state": "AR",
"postal_code": "720324555",
"telephone_number": "501-329-3733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNSIDE",
"first_name": "TIMOTHY",
"middle_name": "PHILLIP TALON",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-07",
"last_updated": "2017-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD14051",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "PD14051",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.