Active NPI
John Russell Dunbar, RPH
- Pharmacist
- Anna, IL
National Provider Identifier
1508466111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051-032883
- Practice address
- 300 Leigh Ave
Anna, IL 62906-2213 - Phone
- (618) 833-8580
- NPI assigned
- Nov 1, 2020
- Last updated
- Nov 1, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051-032883 | IL | Primary |
Addresses
Primary practice location
300 Leigh Ave
Anna, IL 62906-2213
Mailing address
PO Box 8
Marion, IL 62959-0008
Phone (618) 922-0803
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 |
|---|---|---|---|
| 051-032883 | IL | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Anna, IL
- NPI 1629095989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604188800000",
"number": "1508466111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8",
"city": "MARION",
"state": "IL",
"postal_code": "629590008",
"telephone_number": "618-922-0803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 LEIGH AVE",
"city": "ANNA",
"state": "IL",
"postal_code": "629062213",
"telephone_number": "618-833-8580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNBAR",
"first_name": "JOHN",
"middle_name": "RUSSELL",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-01",
"last_updated": "2020-11-01",
"certification_date": "2020-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-032883",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anna, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.