Individual provider Active NPI

Clifford Allen Daugherty, RPH, PHARMD

  • Pharmacist
  • Murfreesboro, TN
National Provider Identifier
1073838637
Registry record updated Dec 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00016468 Issued in WA
Practice address
3400 Lebanon Rd
Murfreesboro, TN 37129-1237
Phone
(615) 225-4600
NPI assigned
Apr 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8958 TN
Pharmacist 183500000X PH00016468 WA Primary

Addresses

Primary practice location

3400 Lebanon Rd
Murfreesboro, TN 37129-1237

Mailing address

1610 Dickens CT
Murfreesboro, TN 37129-0807
Phone (615) 848-2969

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
Credentials
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
8958TNMDSocial Worker
PH00016468WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514073600000",
    "number": "1073838637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 DICKENS CT",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371290807",
            "telephone_number": "615-848-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LEBANON RD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291237",
            "telephone_number": "615-225-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "CLIFFORD",
        "middle_name": "ALLEN",
        "credential": "RPH, PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-07",
        "last_updated": "2017-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "8958",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00016468",
            "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 Dec 24, 2017; 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.