Faneisha Smith, DR

Key facts

NPI

1700564267

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

PD16715 (AR)

Practice address

602 Sheila Dr
West Helena, AR 72390-1823

Phone

(870) 572-6741

NPI assigned

Jul 6, 2023

Sex

Female

Sole proprietor

No

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.

• Walmart Inc. Community/Retail Pharmacy · West Helena, AR · NPI 1417974817
  NPD (past)
• Walmart Inc. Community/Retail Pharmacy · Eastvale, CA · NPI 1770458945
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 28, 2024.

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1700564267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 N VILLAGE DR",
            "city": "WEST HELENA",
            "state": "AR",
            "postal_code": "723901908",
            "telephone_number": "501-830-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 SHEILA DR",
            "city": "WEST HELENA",
            "state": "AR",
            "postal_code": "723901823",
            "telephone_number": "870-572-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "FANEISHA",
        "credential": "DR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD16715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in West Helena, AR · Pharmacist in Arkansas