Active NPI
Matthew Thomas Bird
- Pharmacist
- Fordyce, AR
National Provider Identifier
1619577012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD12866
- Practice address
- 1123 Highway 79 167 Byp
Fordyce, AR 71742-1810 - Phone
- (870) 352-8034
- Fax
- (870) 352-8337
- NPI assigned
- Oct 27, 2020
- Last updated
- Oct 27, 2020
- Sex
- Male
- Sole proprietor
- No
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 | PD12866 | AR | Primary |
Addresses
Primary practice location
1123 Highway 79 167 Byp
Fordyce, AR 71742-1810
Mailing address
29 Valley CT
Sheridan, AR 72150-7061
Phone (870) 917-5799
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 |
|---|---|---|---|
| PD12866 | AR | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603756800000",
"number": "1619577012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 VALLEY CT",
"city": "SHERIDAN",
"state": "AR",
"postal_code": "721507061",
"telephone_number": "870-917-5799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1123 HIGHWAY 79 167 BYP",
"city": "FORDYCE",
"state": "AR",
"postal_code": "717421810",
"telephone_number": "870-352-8034",
"fax_number": "870-352-8337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIRD",
"first_name": "MATTHEW",
"middle_name": "THOMAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-27",
"last_updated": "2020-10-27",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD12866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fordyce, AR
- Donna Arnold, PT
- Pam Bartholomew, MHPP
- BHC Pinnacle Pointe Hospital, Inc. (The Pointe Outpatient Behavioral Health Services)
- Board of Governors of Dallas County Medical Center (Dallas County Medical Center ER Physicians Group)
- Board of Governors of Dallas County Medical Center
- Board of Governors of Dallas County Medical Center (Dallas County Medical Center)
- Board of Governors of Dallas County Medical Center (Dallas County Medical Center Family Clinic)
- Board of Governors of Dallas County Medical Center (Nutt-Walley Clinic of Dallas County Medical Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.