Active NPI
Alexandria Michelle Van Enk
- Community/Retail Pharmacy
- Little Rock, AR
National Provider Identifier
1700561644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PD16194
- Practice address
- 14820 Cantrell Rd
Little Rock, AR 72223-4244 - Phone
- (501) 868-6324
- NPI assigned
- Jun 19, 2023
- Last updated
- Jun 19, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | PD16194 | AR | Primary |
Addresses
Primary practice location
14820 Cantrell Rd
Little Rock, AR 72223-4244
Mailing address
12 Betsy LN
Little Rock, AR 72205-4910
Phone (501) 606-2634
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 |
|---|---|---|---|
| PD16194 | AR | MD | Community/Retail Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Community/Retail Pharmacy | Past | Accepting new patients |
| Walgreen Co | Community/Retail Pharmacy | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687132800000",
"number": "1700561644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 BETSY LN",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722054910",
"telephone_number": "501-606-2634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14820 CANTRELL RD",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722234244",
"telephone_number": "501-868-6324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN ENK",
"first_name": "ALEXANDRIA",
"middle_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-19",
"last_updated": "2023-06-19",
"certification_date": "2022-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "AR",
"license": "PD16194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.