Individual provider Active NPI

Robyn Agnew, PHARM.D.

  • Pharmacist
  • Flowood, MS
National Provider Identifier
1720627474
Registry record updated Dec 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E-09236 Issued in MS
Practice address
110 Promenade Blvd
Flowood, MS 39232-8017
Phone
(601) 718-2233
Fax
(601) 718-2245
NPI assigned
Dec 29, 2019
Last updated
Dec 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 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 E-09236 MS Primary

Addresses

Primary practice location

110 Promenade Blvd
Flowood, MS 39232-8017

Mailing address

110 Promenade Blvd
Flowood, MS 39232-8017
Phone (601) 718-2233

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
E-09236MSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I PastSince Jan 5, 2020 Accepting new patients
Kroger Limited Partnership I PastSince Jan 5, 2020 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": "1577577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577577600000",
    "number": "1720627474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PROMENADE BLVD",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328017",
            "telephone_number": "601-718-2233",
            "fax_number": "601-718-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PROMENADE BLVD",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328017",
            "telephone_number": "601-718-2233",
            "fax_number": "601-718-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNEW",
        "first_name": "ROBYN",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-29",
        "last_updated": "2019-12-29",
        "certification_date": "2019-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-09236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.