Individual provider Active NPI

Mallory Williams, PHARM.D

  • Pharmacist
  • Bella Vista, AR
National Provider Identifier
1679240220
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD15785 Issued in AR
Practice address
3499 Bella Vista Way
Bella Vista, AR 72714-5740
Phone
(479) 273-9155
NPI assigned
Aug 23, 2021
Last updated
Aug 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD15785 AR Primary

Addresses

Primary practice location

3499 Bella Vista Way
Bella Vista, AR 72714-5740

Mailing address

6200 Watkins Ave
Apt. 207
Springdale, AR 72762
Phone (210) 878-5941

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
PD15785ARMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1679240220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 WATKINS AVE",
            "address_2": "APT. 207",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "72762",
            "telephone_number": "210-878-5941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3499 BELLA VISTA WAY",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727145740",
            "telephone_number": "479-273-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MALLORY",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD15785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bella Vista, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.