Active NPI
Kim R Sturgeon
- Pharmacist
- Gleason, TN
National Provider Identifier
1104190743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4362
- Practice address
- 102 Main St
Gleason, TN 38229-7268 - Phone
- (731) 648-5146
- Fax
- (731) 648-5524
- NPI assigned
- Feb 29, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4362 | TN | Primary |
Addresses
Primary practice location
102 Main St
Gleason, TN 38229-7268
Mailing address
120 Penn Dr
Trenton, TN 38382-3803
Phone (731) 343-0854
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4362 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gleason City Drug Store, LLC | Pharmacist | Past | Accepting new patients |
| A&a Apothecary LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Gleason, TN
- NPI 1346690278
-
- Pharmacist
- Gleason, TN
- NPI 1336282227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330473600000",
"number": "1104190743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 PENN DR",
"city": "TRENTON",
"state": "TN",
"postal_code": "383823803",
"telephone_number": "731-343-0854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 MAIN ST",
"city": "GLEASON",
"state": "TN",
"postal_code": "382297268",
"telephone_number": "731-648-5146",
"fax_number": "731-648-5524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STURGEON",
"first_name": "KIM",
"middle_name": "R",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-29",
"last_updated": "2012-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "4362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gleason, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.