Active NPI
Kyler Vaughn
- Pharmacist
- Paragould, AR
National Provider Identifier
1639773575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PN06586
- Practice address
- 1501 W Kingshighway
Paragould, AR 72450-4010 - Phone
- (870) 240-8405
- NPI assigned
- Nov 22, 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 | PN06586 | AR | Primary |
Addresses
Primary practice location
1501 W Kingshighway
Paragould, AR 72450-4010
Mailing address
104 Creekwood Dr
Searcy, AR 72143-8443
Phone (501) 593-1344
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 |
|---|---|---|---|
| PN06586 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Arkansas CVS Pharmacy LLC | 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.
-
- Pharmacy
- North Little Rock, AR
- NPI 1760951602
-
- Pharmacy
- Paragould, AR
- NPI 1609248913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606003200000",
"number": "1639773575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 CREEKWOOD DR",
"city": "SEARCY",
"state": "AR",
"postal_code": "721438443",
"telephone_number": "501-593-1344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 W KINGSHIGHWAY",
"city": "PARAGOULD",
"state": "AR",
"postal_code": "724504010",
"telephone_number": "870-240-8405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHN",
"first_name": "KYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-22",
"last_updated": "2020-11-22",
"certification_date": "2020-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PN06586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paragould, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.