Individual provider Active NPI

Charles Wyatt Thompson, DPH

  • Pharmacist
  • Murfreesboro, TN
National Provider Identifier
1053582924
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5623 Issued in TN
Practice address
5171 Sam Jared Dr
Murfreesboro, TN 37130-1382
Phone
(615) 867-5912
Fax
(615) 867-5759
NPI assigned
Mar 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5623 TN Primary

Addresses

Primary practice location

5171 Sam Jared Dr
Murfreesboro, TN 37130-1382

Mailing address

5171 Sam Jared Dr
Murfreesboro, TN 37130-1382
Phone (615) 867-5912

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

LicenseStateTypeSpecialty
5623TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1053582924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 SAM JARED DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371301382",
            "telephone_number": "615-867-5912",
            "fax_number": "615-867-5759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5171 SAM JARED DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371301382",
            "telephone_number": "615-867-5912",
            "fax_number": "615-867-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CHARLES",
        "middle_name": "WYATT",
        "credential": "DPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "5623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.