Imi Mvere

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

PD14636 Issued in AR

Practice address

178 Highway 167 N
Bald Knob, AR 72010-4058

Phone

(501) 724-2391

NPI assigned

Oct 15, 2018

Last updated

Oct 15, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1942776265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211",
            "city": "WARD",
            "state": "AR",
            "postal_code": "721760211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 HIGHWAY 167 N",
            "city": "BALD KNOB",
            "state": "AR",
            "postal_code": "720104058",
            "telephone_number": "501-724-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MVERE",
        "first_name": "IMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AR",
            "license": "PD14636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS STATE PHARMACIST LICENSE",
            "identifier": "PD14636",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Mason
• Cale E McGillvray, LPC, LMFT
• Brandi Michelle Moody, MCD,CCC-SLP
• Moore Chiropractic Center, P.a.
• Phillip Moore, D.C.
• Shelly Rutledge, PHARM.D.
• Southern Dental Group Bald Knob, PLLC
• Ladonna Sue Thompson, MSE, CCC/SLP
• Wallace Chiropractic Clinic
• Wallace Chiropractic Clinic LLC

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Bald Knob, AR
• Providers in Bald Knob, AR by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.