John Randall Coley, PHARMACIST

Primary specialty

PharmacistTaxonomy code 183500000X

License

3398 Issued in TN

Practice address

1030 Jefferson Ave
Pharmacy Service (119)
Memphis, TN 38104-2127

Phone

(901) 523-8990

Fax

(901) 577-7306

NPI assigned

Aug 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

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.

• VA Medical Center Memphis Pharmacy

  • Department of Veterans Affairs (VA) Pharmacy
  • Memphis, TN
  • NPI 1275750192
  Authorized official Same address or phone

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023126604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 JOSLYN ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381284808",
            "telephone_number": "901-388-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 JEFFERSON AVE",
            "address_2": "PHARMACY SERVICE (119)",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042127",
            "telephone_number": "901-523-8990",
            "fax_number": "901-577-7306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEY",
        "first_name": "JOHN",
        "middle_name": "RANDALL",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "3398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "3398",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nakia Coleman, NNP-BC
• Russell Kevin Coleman, PHARMD
• Thomas Cross Coleman, O.D.
• Tracie Coleman, LCSW
• Dominique Sade Coley, PMHNP-BC
• Amy Le Collie, LPC-MHSP
• Enid Barr Collie, F.N.P.
• Vivian Collier-Nelson
• Janjenette Collier, B.S., M.S.
• Scott Collier, M.D.

• Pharmacist in Memphis, TN
• Providers in Memphis, TN by specialty
• Pharmacist in Tennessee

• 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.

Verify at the official NPI Registry.