Active NPI
Lisa Ann Johnson, R.PH.
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Maumelle, AR
National Provider Identifier
1861772329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- PD06951
- Practice address
- 115 Commons Dr
Maumelle, AR 72113-7266 - Phone
- (501) 803-3274
- NPI assigned
- Aug 27, 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | PD06951 | AR | Primary |
Addresses
Primary practice location
115 Commons Dr
Maumelle, AR 72113-7266
Mailing address
115 Commons Dr
Maumelle, AR 72113-7266
Phone (501) 803-3274
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD06951 | AR | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314403200000",
"number": "1861772329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 COMMONS DR",
"city": "MAUMELLE",
"state": "AR",
"postal_code": "721137266",
"telephone_number": "501-803-3274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 COMMONS DR",
"city": "MAUMELLE",
"state": "AR",
"postal_code": "721137266",
"telephone_number": "501-803-3274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LISA",
"middle_name": "ANN",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-27",
"last_updated": "2011-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "AR",
"license": "PD06951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maumelle, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.