Justin Kyle Petway, ,RPH, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

RPH033084 Issued in GA

Practice address

1310 24TH Ave S
Nashville, TN 37212-2637

Phone

(866) 786-9367

NPI assigned

Oct 12, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1184386542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 24TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122637",
            "telephone_number": "719-210-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 24TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122637",
            "telephone_number": "866-786-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETWAY",
        "first_name": "JUSTIN",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": ",RPH, PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-12",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH033084",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "GA",
            "license": "RPH033084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Pettit
• Petty Orthopaedics, PC
• Damon H Petty, MD
• Leslie Megan Petty, NP
• Taylor Austin Petty, DO
• Jamie Lynn Pfaff, MD
• Emily Welton Pfeffer, N.P.-C
• Kendra Douglas Pfeffer, ACNP
• Megan Leigh Pfeffer, D.C., A.T.C.
• Jessica Emily Pfeifer, MS

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Nashville, TN
• Providers in Nashville, TN by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.