Active NPI
Laura Jo Gardner, PHARM.D.
- Pharmacist
- Potts Camp, MS
National Provider Identifier
1801192257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E09336
- Practice address
- 41 S Center St
Potts Camp, MS 38659-9531 - Phone
- (662) 333-7782
- NPI assigned
- Feb 2, 2011
- Last updated
- Feb 2, 2011
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | E09336 | MS | Primary |
Addresses
Primary practice location
41 S Center St
Potts Camp, MS 38659-9531
Mailing address
525 Highway 30 W
Baldwyn, MS 38824-9051
Phone (662) 365-5534
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
| License | State | Type | Specialty |
|---|---|---|---|
| E09336 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tyson Drug Inc | Past | Accepting new patients | |
| Tyson Drugs Inc | 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.
-
- Community/Retail Pharmacy
- Holly Springs, MS
- NPI 1972508695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296604800000",
"number": "1801192257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 HIGHWAY 30 W",
"city": "BALDWYN",
"state": "MS",
"postal_code": "388249051",
"telephone_number": "662-365-5534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 S CENTER ST",
"city": "POTTS CAMP",
"state": "MS",
"postal_code": "386599531",
"telephone_number": "662-333-7782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "LAURA",
"middle_name": "JO",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-02",
"last_updated": "2011-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E09336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Potts Camp, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.