Active NPI
Brent Emerson
- Pharmacy Technician
- Bentonville, AR
National Provider Identifier
1992521439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- PT11092
- Practice address
- 1400 N Walton Blvd
Bentonville, AR 72712-4676 - Phone
- (479) 268-9830
- Fax
- (479) 268-9831
- NPI assigned
- Nov 30, 2024
- Last updated
- Nov 30, 2024
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | PT11092 | AR | Primary |
Addresses
Primary practice location
1400 N Walton Blvd
Bentonville, AR 72712-4676
Mailing address
420 Carlson St
Centerton, AR 72719-8814
Phone (479) 412-8308
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 |
|---|---|---|---|
| PT11092 | AR | MD | Pharmacy Technician |
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": "1732924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732924800000",
"number": "1992521439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 CARLSON ST",
"city": "CENTERTON",
"state": "AR",
"postal_code": "727198814",
"telephone_number": "479-412-8308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 N WALTON BLVD",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727124676",
"telephone_number": "479-268-9830",
"fax_number": "479-268-9831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMERSON",
"first_name": "BRENT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-30",
"last_updated": "2024-11-30",
"certification_date": "2024-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "AR",
"license": "PT11092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.