Individual provider Active NPI

Robert Johnson Jr., PHARM. D.

  • Pharmacist
  • Bartlett, TN
National Provider Identifier
1154073195
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
45591 Issued in TN
Practice address
6520 Memphis Arlington Rd
Bartlett, TN 38135-2402
Phone
(901) 388-4331
NPI assigned
Jan 20, 2022
Last updated
Jan 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 45591 TN Primary

Addresses

Primary practice location

6520 Memphis Arlington Rd
Bartlett, TN 38135-2402

Mailing address

2399 Ridgeway Rd
Memphis, TN 38119-7413
Phone (901) 515-8563

Other identifiers 1

IdentifierTypeStateIssuer
45591OtherTNPHARMACIST LICENSE FROM TN BOARD OF PHARMACY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address r0j04z0.s03599@us.wal-mart.com Direct

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

LicenseStateTypeSpecialty
45591TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East, LP PastSince Jan 26, 2022 Accepting new patients
Wal-Mart Stores East LP PastSince Jan 26, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1154073195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2399 RIDGEWAY RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381197413",
            "telephone_number": "901-515-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 MEMPHIS ARLINGTON RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381352402",
            "telephone_number": "901-388-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "45591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE FROM TN BOARD OF PHARMACY",
            "identifier": "45591",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "r0j04z0.s03599@us.wal-mart.com",
            "affiliation": "N",
            "endpointDescription": "Work email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6520 Memphis Arlington Rd",
            "city": "Bartlett",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381352402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.