Active NPI
Mackenzie Jo King, PHARM. D
- Pharmacist
- Mountain Home, AR
National Provider Identifier
1629705108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD16286
- Practice address
- 65 Wal Mart Dr
Mountain Home, AR 72653-6784 - Phone
- (870) 492-7733
- NPI assigned
- Aug 4, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD16286 | AR | Primary |
Addresses
Primary practice location
65 Wal Mart Dr
Mountain Home, AR 72653-6784
Mailing address
930 Windbrook St
Mountain Home, AR 72653-3763
Phone (870) 656-6912
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
| License | State | Type | Specialty |
|---|---|---|---|
| PD16286 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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 and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701216000000",
"number": "1629705108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "930 WINDBROOK ST",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726533763",
"telephone_number": "870-656-6912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 WAL MART DR",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726536784",
"telephone_number": "870-492-7733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "MACKENZIE",
"middle_name": "JO",
"credential": "PHARM. D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-04",
"last_updated": "2023-11-29",
"certification_date": "2023-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD16286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.