Individual provider Active NPI

Robert Edward Higginbottom, DPH.

  • Pharmacist
  • Savannah, TN
National Provider Identifier
1023248994
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
02769 Issued in TN
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, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1023248994OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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.

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
02769TNMDGeriatric 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.

Verify at the official NPI Registry.