NPIMap

Individual provider Active NPI

Jacob Beard

  • Pharmacist
  • Wichita Falls, TX
National Provider Identifier
1669039541
Registry record updated May 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
58088 Issued in TX
Practice address
4426 Kell Blvd
Wichita Falls, TX 76309-4719
Phone
(940) 692-7081
NPI assigned
May 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 58088 TX Primary

Addresses

Primary practice location

4426 Kell Blvd
Wichita Falls, TX 76309-4719

Mailing address

5121 Reyes St
Wichita Falls, TX 76306-1364
Phone (940) 692-7081

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

LicenseStateTypeSpecialty
58088TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Harvest Drug & Gift LP Pharmacist Past Accepting new patients
Harvest Drug & Gift LP PastSince Sep 10, 2023 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.

NPI Registry JSON

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

{
    "created_epoch": "1558742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558742400000",
    "number": "1669039541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 REYES ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763061364",
            "telephone_number": "940-692-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4426 KELL BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094719",
            "telephone_number": "940-692-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARD",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-25",
        "last_updated": "2019-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "58088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2019; 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.