Active NPI
Jahnaja Dismuke
- Pharmacy Technician
- Monticello, AR
National Provider Identifier
1962282970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- Practice address
- 640 W Gaines St
Monticello, AR 71655-4675 - Phone
- (870) 367-6146
- NPI assigned
- Oct 5, 2023
- Last updated
- Oct 5, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | Primary |
Addresses
Primary practice location
640 W Gaines St
Monticello, AR 71655-4675
Mailing address
707 McCauley St
Warren, AR 71671-3232
Phone (870) 820-4216
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
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, 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": "1696464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696464000000",
"number": "1962282970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 MCCAULEY ST",
"city": "WARREN",
"state": "AR",
"postal_code": "716713232",
"telephone_number": "870-820-4216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 W GAINES ST",
"city": "MONTICELLO",
"state": "AR",
"postal_code": "716554675",
"telephone_number": "870-367-6146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISMUKE",
"first_name": "JAHNAJA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-05",
"last_updated": "2023-10-05",
"certification_date": "2023-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monticello, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.