Active NPI
Jason Spener Mabry
- Pharmacist
- Berryville, AR
National Provider Identifier
1700200144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD-09326
- Practice address
- 1006 West Trimble Ave
Berryville, AR 72616 - Phone
- (870) 423-2094
- NPI assigned
- Feb 5, 2014
- 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 | PD-09326 | AR | Primary |
Addresses
Primary practice location
1006 West Trimble Ave
Berryville, AR 72616
Mailing address
1006 W Trimble Ave
Berryville, AR 72616-4618
Phone (870) 423-2094
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 |
|---|---|---|---|
| PD-09326 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GWL Inc | Current | Accepting new patients | |
| GWL Inc | Current | Accepting new patients |
Locations
1006 W Trimble Ave
Berryville, AR 72616
Phone (870) 423-2094
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.
-
- Long Term Care Pharmacy
- Berryville, AR
- NPI 1760253561
-
- Community/Retail Pharmacy
- Berryville, AR
- NPI 1447364419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706745600000",
"number": "1700200144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1006 W TRIMBLE AVE",
"city": "BERRYVILLE",
"state": "AR",
"postal_code": "726164618",
"telephone_number": "870-423-2094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1006 WEST TRIMBLE AVE",
"city": "BERRYVILLE",
"state": "AR",
"postal_code": "72616",
"telephone_number": "870-423-2094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MABRY",
"first_name": "JASON",
"middle_name": "SPENER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-05",
"last_updated": "2024-02-01",
"certification_date": "2024-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD-09326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berryville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.