Individual provider Active NPI

Mary Ann McAllen, PHARM D

  • Pharmacy
  • North Little Rock, AR
National Provider Identifier
1568060275
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PD15123 Issued in AR
Practice address
760 Michaela Dr
North Little Rock, AR 72117-5361
Phone
(501) 992-1006
NPI assigned
Oct 14, 2020
Last updated
Oct 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PD15123 AR Primary

Addresses

Primary practice location

760 Michaela Dr
North Little Rock, AR 72117-5361

Mailing address

760 Michaela Dr
North Little Rock, AR 72117-5361
Phone (501) 992-1006

Other identifiers 1

IdentifierTypeStateIssuer
PD15123MedicaidAR

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

LicenseStateTypeSpecialty
PD15123ARMDPharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Pharmacy Care LLC Pharmacy PastSince Oct 19, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1568060275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 MICHAELA DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721175361",
            "telephone_number": "501-992-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 MICHAELA DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721175361",
            "telephone_number": "501-992-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCALLEN",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AR",
            "license": "PD15123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD15123",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.

Verify at the official NPI Registry.