Penny Ann Sullivan-Green, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD16404 Issued in AR

Practice address

508 E Walnut St
Paris, AR 72855-4019

Phone

(479) 963-6400

Fax

(479) 963-2103

NPI assigned

Nov 6, 2006

Last updated

Jul 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• SCPG Arkansas LLC

  dba Express Rx of Paris

  • Community/Retail Pharmacy
  • Paris, AR
  • NPI 1104184332
  NPD
• Walmart Inc.

  • Community/Retail Pharmacy
  • Booneville, AR
  • NPI 1780601179
  NPD (past)
• WPM Community Pharmacies LLC

  dba Allcare Pharmacy

  • Community/Retail Pharmacy
  • Arkadelphia, AR
  • NPI 1629148705
  NPD (past)
• Walmart Inc.

  dba Walmart Pharmacy 10-3129

  • Community/Retail Pharmacy
  • Eastvale, CA
  • NPI 1770458945
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1609955863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 N REVEILLE ST",
            "city": "MAGAZINE",
            "state": "AR",
            "postal_code": "729438422",
            "telephone_number": "817-991-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 E WALNUT ST",
            "city": "PARIS",
            "state": "AR",
            "postal_code": "728554019",
            "telephone_number": "479-963-6400",
            "fax_number": "479-963-2103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 E Main St",
            "address_purpose": "LOCATION",
            "city": "Booneville",
            "state": "AR",
            "postal_code": "729276932",
            "country_code": "US",
            "telephone_number": "479-675-5341",
            "fax_number": "479-675-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN-GREEN",
        "first_name": "PENNY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "33123",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD16404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Matthews Spivey, D.D.S.
• Anita Spradling, QBHP
• State of Arkansas (Logan County Health Unit /Paris)
• Jonas Strobel
• Stephen Stroud
• Superintendent of Paris Public Schools
• Superintendent of Paris Public Schools
• The Guidance Center - Paris Clinic
• The Guidance Center - RCF Paris (WACGC-RCF Paris)
• Thomas M. Spivey, D.D.S., P.a.

• Pharmacist in Paris, AR
• Providers in Paris, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.