Individual provider Active NPI

Gary Bentley Bass

  • Pharmacist
  • Little Rock, AR
National Provider Identifier
1558554303
Registry record updated Aug 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
06935 Issued in AR
Practice address
1801 Broadway St
Little Rock, AR 72206-1222
Phone
(501) 374-6565
Fax
(501) 374-6231
NPI assigned
Aug 24, 2007
Last updated
Aug 24, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 06935 AR Primary

Addresses

Primary practice location

1801 Broadway St
Little Rock, AR 72206-1222

Mailing address

1801 Broadway St
Little Rock, AR 72206-1222
Phone (501) 374-6565

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

LicenseStateTypeSpecialty
06935ARMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187913600000",
    "number": "1558554303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 BROADWAY ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722061222",
            "telephone_number": "501-374-6565",
            "fax_number": "501-374-6231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 BROADWAY ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722061222",
            "telephone_number": "501-374-6565",
            "fax_number": "501-374-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "GARY",
        "middle_name": "BENTLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-24",
        "last_updated": "2007-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "06935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.