Active NPI
Richard Crusenberry Jr., PHARM.D.
- Pharmacist
- Fall Branch, TN
National Provider Identifier
1144579020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12057
- Practice address
- 1714 Highway 93
Suite 11
Fall Branch, TN 37656-1763 - Phone
- (423) 348-6101
- NPI assigned
- Sep 6, 2012
- Sex
- Male
- Sole proprietor
- No
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 | 12057 | TN | Primary |
Addresses
Primary practice location
1714 Highway 93
Suite 11
Fall Branch, TN 37656-1763
Mailing address
1185 W Mountain View Rd
Apt 2122
Johnson City, TN 37604-2523
Phone (423) 915-6977
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12057 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark H Kolarsky | Past | Accepting new patients | |
| Rowan Enterprises Inc | 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
- Fall Branch, TN
- NPI 1790186401
-
- Community/Retail Pharmacy
- Fall Branch, TN
- NPI 1659408490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346889600000",
"number": "1144579020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1185 W MOUNTAIN VIEW RD",
"address_2": "APT 2122",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042523",
"telephone_number": "423-915-6977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1714 HIGHWAY 93",
"address_2": "SUITE 11",
"city": "FALL BRANCH",
"state": "TN",
"postal_code": "376561763",
"telephone_number": "423-348-6101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUSENBERRY",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-06",
"last_updated": "2012-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "12057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fall Branch, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.