Active NPI
Barry Dayton Criddle, R.PH.
- Pharmacist
- Vardaman, MS
National Provider Identifier
1659898328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-07893
- Practice address
- 101 W Sweet Potato St
Vardaman, MS 38878-9433 - Phone
- (662) 682-7489
- NPI assigned
- Aug 24, 2017
- 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 | E-07893 | MS | Primary |
Addresses
Primary practice location
101 W Sweet Potato St
Vardaman, MS 38878-9433
Mailing address
2504 Philp Dr
Tupelo, MS 38801-6109
Phone (662) 549-5232
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 800278784 | Other | MS | MS DRIVERS LICENSE |
| E-07893 | Other | MS | MS BOARD OF PHARMACY LICENSE |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-07893 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529452800000",
"number": "1659898328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2504 PHILP DR",
"city": "TUPELO",
"state": "MS",
"postal_code": "388016109",
"telephone_number": "662-549-5232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W SWEET POTATO ST",
"city": "VARDAMAN",
"state": "MS",
"postal_code": "388789433",
"telephone_number": "662-682-7489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRIDDLE",
"first_name": "BARRY",
"middle_name": "DAYTON",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-24",
"last_updated": "2018-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-07893",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MS DRIVERS LICENSE",
"identifier": "800278784",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MS BOARD OF PHARMACY LICENSE",
"identifier": "E-07893",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vardaman, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.