Active NPI
Robert Edward Higginbottom, DPH.
- Pharmacist
- Savannah, TN
National Provider Identifier
1023248994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 02769
- Practice address
- 765B Florence Rd # RS
Savannah, TN 38372-3101 - Phone
- (731) 925-3956
- Fax
- (731) 925-8754
- NPI assigned
- Jul 24, 2009
- Last updated
- Jun 20, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 02769 | TN | Primary |
| Geriatric Pharmacist | 1835G0303X | 02769 | TN |
Addresses
Primary practice location
765B Florence Rd # RS
Savannah, TN 38372-3101
Mailing address
765B Florence Rd # RS
Savannah, TN 38372-3101
Phone (731) 925-3956
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023248994 | Other | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090803000733 | TN | Practitioner - Mass Immunization Roster Biller | 2769534544 | Practice locations: Savannah, TN |
| O20100930020009 | TN | DME Supplier - Pharmacy | 0244382935 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Savannah, TN |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba The Prescription Shop
- Community/Retail Pharmacy
- Savannah, TN
- NPI 1508994260
O20100930020009
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02769 | TN | MD | Geriatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687219200000",
"number": "1023248994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "765B FLORENCE RD # RS",
"city": "SAVANNAH",
"state": "TN",
"postal_code": "383723101",
"telephone_number": "731-925-3956",
"fax_number": "731-925-8754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "765B FLORENCE RD # RS",
"city": "SAVANNAH",
"state": "TN",
"postal_code": "383723101",
"telephone_number": "731-925-3956",
"fax_number": "731-925-8754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIGGINBOTTOM",
"first_name": "ROBERT",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DPH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-24",
"last_updated": "2023-06-20",
"certification_date": "2023-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "02769",
"primary": true
},
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "TN",
"license": "02769",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1023248994",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Savannah, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.