Individual provider Active NPI

Kelly Rosenbaum, PHARMD

  • Pharmacist
  • Knoxville, TN
National Provider Identifier
1205502853
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
36924 Issued in TN
Practice address
9352 Park West Blvd
Knoxville, TN 37923-4325
Phone
(865) 373-1042
NPI assigned
Aug 23, 2021
Last updated
Aug 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 36924 TN Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 36924 TN

Addresses

Primary practice location

9352 Park West Blvd
Knoxville, TN 37923-4325

Mailing address

9901 Martha Knight Cir
Knoxville, TN 37932-1682
Phone (865) 898-1883

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
36924TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1205502853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 MARTHA KNIGHT CIR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321682",
            "telephone_number": "865-898-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9352 PARK WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234325",
            "telephone_number": "865-373-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "36924",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TN",
            "license": "36924",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.