Individual provider Active NPI

Samuel Andrew Myers, PHARM.D.

  • Pharmacist
  • Oxford, MS
National Provider Identifier
1801506043
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E-11824 Issued in MS
Practice address
653 Concordia Ave
Oxford, MS 38655-1982
Phone
(662) 638-6382
Fax
(833) 623-3054
NPI assigned
Nov 29, 2022
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16903 MS
Pharmacist 183500000X E-11824 MS Primary

Addresses

Primary practice location

653 Concordia Ave
Oxford, MS 38655-1982

Mailing address

302 Lakewood Hill Drive
Oxford, MS 38655
Phone (662) 352-4145

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
16903MSMDPharmacist
E-11824MSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Myers Pharmacy LLC CurrentSince Dec 3, 2023 Accepting new patients
Myers Apothecary CurrentSince Jun 30, 2024 Accepting new patients

Locations

653 Concordia Ave
Oxford, MS 38655
Phone (662) 352-4145

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": "1669680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1801506043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 LAKEWOOD HILL DRIVE",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "38655",
            "telephone_number": "662-352-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 CONCORDIA AVE",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386551982",
            "telephone_number": "662-638-6382",
            "fax_number": "833-623-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "SAMUEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-29",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "16903",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-11824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.

Verify at the official NPI Registry.