Active NPI
Martha Guadalupe Gann, PD13255
- Pharmacist
- Springdale, AR
National Provider Identifier
1508467085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD13255
- Practice address
- 2004 S Pleasant St
Springdale, AR 72764-6298 - Phone
- (478) 756-0860
- NPI assigned
- Nov 3, 2020
- 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 | PD13255 | AR | Primary |
Addresses
Primary practice location
2004 S Pleasant St
Springdale, AR 72764-6298
Mailing address
452 Sunset Dr
Cave Springs, AR 72718-8824
Phone (479) 856-1819
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 |
|---|---|---|---|
| PD13255 | AR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604361600000",
"number": "1508467085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "452 SUNSET DR",
"city": "CAVE SPRINGS",
"state": "AR",
"postal_code": "727188824",
"telephone_number": "479-856-1819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2004 S PLEASANT ST",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727646298",
"telephone_number": "478-756-0860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANN",
"first_name": "MARTHA",
"middle_name": "GUADALUPE",
"credential": "PD13255",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-03",
"last_updated": "2020-11-03",
"certification_date": "2020-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD13255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.