Active NPI
Mark C Phelps, PHARMD
- Pharmacist
- Killeen, TX
National Provider Identifier
1821328774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS35094
- Practice address
- 1000 E Central Texas Expy
Walgreens #10711
Killeen, TX 76541 - Phone
- (254) 526-4258
- Fax
- (254) 526-8809
- NPI assigned
- Dec 28, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 45669 | TX | |
| Pharmacist | 183500000X | PS35094 | FL | Primary |
Addresses
Primary practice location
1000 E Central Texas Expy
Walgreens #10711
Killeen, TX 76541
Mailing address
1000 E Centex Expy
Walgreens #10711
Killeen, TX 76541
Phone (254) 526-4258
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 |
|---|---|---|---|
| PS35094 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261958400000",
"number": "1821328774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 E CENTEX EXPY",
"address_2": "WALGREENS #10711",
"city": "KILLEEN",
"state": "TX",
"postal_code": "76541",
"telephone_number": "254-526-4258",
"fax_number": "254-526-8809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E CENTRAL TEXAS EXPY",
"address_2": "WALGREENS #10711",
"city": "KILLEEN",
"state": "TX",
"postal_code": "76541",
"telephone_number": "254-526-4258",
"fax_number": "254-526-8809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHELPS",
"first_name": "MARK",
"middle_name": "C",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-12-28",
"last_updated": "2009-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "45669",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS35094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Killeen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.