Individual provider Active NPI

Bethany Wilks, PHARM.D.

  • Pharmacist
  • Dyersburg, TN
National Provider Identifier
1821221961
Registry record updated Aug 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9128 Issued in TN
Practice address
1502 Brayton Avenue
Dyersburg, TN 38024
Phone
(731) 285-7267
Fax
(731) 287-0438
NPI assigned
Aug 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 9128 TN Primary

Addresses

Primary practice location

1502 Brayton Avenue
Dyersburg, TN 38024

Mailing address

1492 Yellow Twig Lane
Dyersburg, TN 38024
Phone (731) 286-4405

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
9128TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
James and Wilks Pharmacy LLC Current Accepting new patients

Locations

620 Mall Blvd
Ste A
Dyersburg, TN 38024
Phone (731) 286-2025

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251072000000",
    "number": "1821221961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 YELLOW TWIG LANE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "38024",
            "telephone_number": "731-286-4405",
            "fax_number": "731-287-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 BRAYTON AVENUE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "38024",
            "telephone_number": "731-285-7267",
            "fax_number": "731-287-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKS",
        "first_name": "BETHANY",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2009-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "9128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; 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.