Active NPI
Ray Howe Irwin Jr.
- Pharmacist
- La Follette, TN
National Provider Identifier
1205110491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 08332
- Practice address
- 2109 Jacksboro Pike
La Follette, TN 37766-3003 - Phone
- (423) 566-0774
- Fax
- (423) 566-0864
- NPI assigned
- Oct 5, 2011
- 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 | 08332 | TN | Primary |
Addresses
Primary practice location
2109 Jacksboro Pike
La Follette, TN 37766-3003
Mailing address
235 Hilltop LN
Jacksboro, TN 37757-3036
Phone (423) 562-3360
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08332 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317772800000",
"number": "1205110491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 HILLTOP LN",
"city": "JACKSBORO",
"state": "TN",
"postal_code": "377573036",
"telephone_number": "423-562-3360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2109 JACKSBORO PIKE",
"city": "LA FOLLETTE",
"state": "TN",
"postal_code": "377663003",
"telephone_number": "423-566-0774",
"fax_number": "423-566-0864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRWIN",
"first_name": "RAY",
"middle_name": "HOWE",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-05",
"last_updated": "2011-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "08332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Follette, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.