Krista Jo Shouse

Primary specialty

PharmacistTaxonomy code 183500000X

License

35999 Issued in TN

Practice address

923 E Central Ave
La Follette, TN 37766-2768

Phone

(423) 907-1200

Fax

(423) 907-1492

NPI assigned

Apr 3, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1124657960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 MYERS ST",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "377572223",
            "telephone_number": "423-494-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 E CENTRAL AVE",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377662768",
            "telephone_number": "423-907-1200",
            "fax_number": "423-907-1492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Independence Ln",
            "address_purpose": "LOCATION",
            "city": "LA Follette",
            "state": "TN",
            "postal_code": "377663031",
            "country_code": "US",
            "telephone_number": "423-562-4444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOUSE",
        "first_name": "KRISTA",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "35999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in La Follette, TN
• Providers in La Follette, TN by specialty
• Pharmacist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.