Active NPI
Paul Griffin
- Pharmacist
- Fayetteville, AR
National Provider Identifier
1912509266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD06972
- Practice address
- 2690 E Citizens Dr
Fayetteville, AR 72703-4339 - Phone
- (479) 571-6673
- NPI assigned
- Nov 11, 2020
- Last updated
- Nov 11, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD06972 | AR | Primary |
Addresses
Primary practice location
2690 E Citizens Dr
Fayetteville, AR 72703-4339
Mailing address
1097 E Broadview Dr
Fayetteville, AR 72703-2058
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD06972 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | 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, 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": "1605052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605052800000",
"number": "1912509266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1097 E BROADVIEW DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727032058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2690 E CITIZENS DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034339",
"telephone_number": "479-571-6673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIFFIN",
"first_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-11",
"last_updated": "2020-11-11",
"certification_date": "2020-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD06972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.