Jimmy Chokbengboun, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD14168 Issued in AR

Practice address

1112 Towson Ave
Fort Smith, AR 72901-5002

Phone

(479) 782-9210

Fax

(479) 782-0023

NPI assigned

Jun 29, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Prince Drug Store Inc

  • Community/Retail Pharmacy
  • Fort Smith, AR
  • NPI 1417039298
  NPD (past)

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1831821776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 TOWSON AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729015002",
            "telephone_number": "479-782-9210",
            "fax_number": "479-782-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 TOWSON AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729015002",
            "telephone_number": "479-782-9210",
            "fax_number": "479-782-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOKBENGBOUN",
        "first_name": "JIMMY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD14168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Children'S Center for Development
• Amanda Gayle Chilton, PT
• Justin Ezekwem Chinwah, MD
• Stephen D Chiovoloni, DSW, LCSW
• Amanda G. Chisum-Price, MD
• Winchell Chow
• Christa Means Counseling Services
• Barbara Christensen, OTR
• Emily Amanda Christensen, APRN, FNP-C
• Deborah Christian, QBHP

• Pharmacist in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.