Active NPI
Keith Jerome McWilliams, RPH
- Pharmacist
- Chattanooga, TN
National Provider Identifier
1164855169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 011335
- Practice address
- 1200 Dodson Ave
Chattanooga, TN 37406-3214 - Phone
- (423) 386-1107
- Fax
- (423) 698-8288
- NPI assigned
- Aug 13, 2013
- Last updated
- Aug 13, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 011335 | TN | Primary |
| Pharmacist | 183500000X | RPH014334 | GA | |
| Pharmacist | 183500000X | 10572 | AL |
Addresses
Primary practice location
1200 Dodson Ave
Chattanooga, TN 37406-3214
Mailing address
1200 Dodson Ave
Chattanooga, TN 37406-3214
Phone (423) 386-1107
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10572 | AL | MD | Pharmacist |
| RPH014334 | GA | MD | Pharmacist |
| 011335 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376352000000",
"number": "1164855169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 DODSON AVE",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374063214",
"telephone_number": "423-386-1107",
"fax_number": "423-698-8288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 DODSON AVE",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374063214",
"telephone_number": "423-386-1107",
"fax_number": "423-698-8288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCWILLIAMS",
"first_name": "KEITH",
"middle_name": "JEROME",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-13",
"last_updated": "2013-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "011335",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH014334",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "10572",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chattanooga, TN
- Nikki McPherson, LCSW
- Courtney Burtnett McQuistan, OTR/L, OTD
- Arleigh McRae, REGISTERED NURSE
- Shannon D McShan, APRN
- Robert L. McVie, NURSE PRACTITIONER
- MD Physical Therapy Center for Longevity (Marion Markettia Duncan)
- MD Total Care, LLC
- MDP Management LLC
- Me Homecare LLC (A Better Solution in Home Care Chattanooga)
- Melissa Meade, LPC/MHSP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.