Active NPI
Dakota Ryan Harrell
- Pharmacist
- Bossier City, LA
National Provider Identifier
1629681903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.023558
- Practice address
- 3001 E Texas St
Bossier City, LA 71111-3207 - Phone
- (318) 742-7207
- NPI assigned
- Aug 26, 2020
- Last updated
- Aug 26, 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 | PST.023558 | LA | Primary |
Addresses
Primary practice location
3001 E Texas St
Bossier City, LA 71111-3207
Mailing address
1108 Cloverdale Dr
Shreveport, LA 71118-3247
Phone (318) 771-1856
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 |
|---|---|---|---|
| PST.023558 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598400000000",
"number": "1629681903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 CLOVERDALE DR",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711183247",
"telephone_number": "318-771-1856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 E TEXAS ST",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711113207",
"telephone_number": "318-742-7207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "DAKOTA",
"middle_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-26",
"last_updated": "2020-08-26",
"certification_date": "2020-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.023558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bossier City, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.