Active NPI
Johnny Paul, DPH
- Pharmacist
- Smithville, TN
National Provider Identifier
1023007697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- C006677
- Practice address
- 516-B West Main Street
Smithville, TN 37166-0299 - Phone
- (615) 597-7822
- Fax
- (615) 597-1112
- NPI assigned
- Oct 17, 2005
- 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 | C006677 | TN | Primary |
Addresses
Primary practice location
516-B West Main Street
Smithville, TN 37166-0299
Mailing address
P. O. Box 126
Smithville, TN 37166-1118
Phone (615) 597-7822
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 150553 | Other | TN | BC/BS |
| 4427313 | Other | TN | NCPDP |
| 9449808 | Medicaid | TN | |
| 3563964 | Other | TN | TN MEDICAL ASSISTANCE PRO |
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 |
|---|---|---|---|
| C006677 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SGJ & P Inc | Pharmacist | Current | Accepting new patients |
| SGJ & P Inc | Current | Accepting new patients |
Locations
516 W Main St
Ste B
Smithville, TN 37166
Phone (615) 597-7822
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.
-
- Durable Medical Equipment & Medical Supplies
- Smithville, TN
- NPI 1689655250
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023007697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P. O. BOX 126",
"city": "SMITHVILLE",
"state": "TN",
"postal_code": "371661118",
"telephone_number": "615-597-7822",
"fax_number": "615-597-1112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516-B WEST MAIN STREET",
"city": "SMITHVILLE",
"state": "TN",
"postal_code": "371660299",
"telephone_number": "615-597-7822",
"fax_number": "615-597-1112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUL",
"first_name": "JOHNNY",
"name_prefix": "Mr.",
"credential": "DPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "C006677",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "150553",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "4427313",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9449808",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TN MEDICAL ASSISTANCE PRO",
"identifier": "3563964",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Smithville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.