NPIMap

Organization Active NPI

Kroger

  • Pharmacy
  • Knoxville, TN
National Provider Identifier
1043691009
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
39228 Issued in TN
Legal business name
KROGER
Practice address
2217 N Broadway St
Knoxville, TN 37917-4719
Phone
(865) 525-4629
NPI assigned
Jun 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Karla Langworthy
Title
Manager of Pharmacy Credentialing
Phone
(513) 698-1878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 39228 TN Primary

Addresses

Primary practice location

2217 N Broadway St
Knoxville, TN 37917-4719

Mailing address

2217 N Broadway St
Knoxville, TN 37917-4719

National Provider Directory

National Provider Directory
Tax ID family
Kroger 423611 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1043691009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 N BROADWAY ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379174719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 N BROADWAY ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379174719",
            "telephone_number": "865-525-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KROGER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "LANGWORTHY",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY CREDENTIALING",
        "authorized_official_telephone_number": "513-698-1878"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "39228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.