Active NPI
Alexis Summerville McDavis
- Pharmacist
- Olive Branch, MS
National Provider Identifier
1629565684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- R-010650
- Practice address
- 7950 Craft Goodman Frontage Rd
Olive Branch, MS 38654 - Phone
- (662) 890-5868
- NPI assigned
- Apr 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | R-010650 | MS | Primary |
| Pharmacist | 183500000X | 32277 | TN |
Addresses
Primary practice location
7950 Craft Goodman Frontage Rd
Olive Branch, MS 38654
Mailing address
7950 Craft Goodman Frontage Rd
Olive Branch, MS 38654
Phone (662) 890-5868
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 |
|---|---|---|---|
| R-010650 | MS | MD | Pharmacist |
| 32277 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523836800000",
"number": "1629565684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7950 CRAFT GOODMAN FRONTAGE RD",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "38654",
"telephone_number": "662-890-5868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7950 CRAFT GOODMAN FRONTAGE RD",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "38654",
"telephone_number": "662-890-5868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDAVIS",
"first_name": "ALEXIS",
"middle_name": "SUMMERVILLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-16",
"last_updated": "2018-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "R-010650",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "32277",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olive Branch, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.