Individual provider Active NPI

Ben McManus, PHARMD

  • Pharmacist
  • Tupelo, MS
National Provider Identifier
1639449804
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E-010113 Issued in MS
Practice address
902 S Gloster St
Tupelo, MS 38801-6312
Phone
(662) 844-1318
NPI assigned
Jan 5, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E-010113 MS Primary

Addresses

Primary practice location

902 S Gloster St
Tupelo, MS 38801-6312

Mailing address

902 S Gloster St
Tupelo, MS 38801-6312
Phone (662) 844-1318

Other identifiers 1

IdentifierTypeStateIssuer
00330654MedicaidMS

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

LicenseStateTypeSpecialty
E-010113MSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Dec 28, 2022 Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Dec 28, 2022 Accepting new patients

Locations

902 S Gloster St
Tupelo, MS 38801
Phone (662) 844-1318

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1639449804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016312",
            "telephone_number": "662-844-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016312",
            "telephone_number": "662-844-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANUS",
        "first_name": "BEN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-05",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-010113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00330654",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.