Individual provider Active NPI

Wade Gilreath

  • Pharmacist
  • Hixson, TN
National Provider Identifier
1063765642
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9837 Issued in TN
Practice address
5380 Highway 153
Hixson, TN 37343-4946
Phone
(423) 870-8562
NPI assigned
Oct 19, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 9837 TN Primary
Pharmacist 183500000X 19113 GA

Addresses

Primary practice location

5380 Highway 153
Hixson, TN 37343-4946

Mailing address

228 E Tennant Cir
Chickamauga, GA 30707-1611
Phone (423) 309-9233

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
19113GAMDPharmacist
9837TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1063765642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 E TENNANT CIR",
            "city": "CHICKAMAUGA",
            "state": "GA",
            "postal_code": "307071611",
            "telephone_number": "423-309-9233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 HIGHWAY 153",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434946",
            "telephone_number": "423-870-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILREATH",
        "first_name": "WADE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "9837",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "19113",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.