Active NPI
Charnell Whitfield Middlecoff III, DPH
- Pharmacist
- Somerville, TN
National Provider Identifier
1205915865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3438
- Practice address
- 13092 N Main Street
Super Drugs
Somerville, TN 38068-1421 - Phone
- (901) 465-9888
- Fax
- (901) 465-6906
- NPI assigned
- Nov 3, 2006
- Last updated
- Jul 8, 2007
- 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 | 3438 | TN | Primary |
Addresses
Primary practice location
13092 N Main Street
Super Drugs
Somerville, TN 38068-1421
Mailing address
145 Country Club Rd
Somerville, TN 38068
Phone (901) 465-9020
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 |
|---|---|---|---|
| 3438 | TN | MD | Pharmacist |
Organizations & group practices 1
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": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205915865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 COUNTRY CLUB RD",
"city": "SOMERVILLE",
"state": "TN",
"postal_code": "38068",
"telephone_number": "901-465-9020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13092 N MAIN STREET",
"address_2": "SUPER DRUGS",
"city": "SOMERVILLE",
"state": "TN",
"postal_code": "380681421",
"telephone_number": "901-465-9888",
"fax_number": "901-465-6906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIDDLECOFF",
"first_name": "CHARNELL",
"middle_name": "WHITFIELD",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "3438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerville, TN
- Methodist Healthcare - Fayette Hospital
- Methodist Healthcare - Fayette Hospital
- Methodist Specialty Physician, V, LLC (McGee General Surgery Clinic)
- Middlecoff Dental Group PLLC
- Middlecoff Super D Drugs 116 Inc (super drugs)
- Mary K Middlecoff, DDS
- William J Middlecoff, DDS
- David Miedema, MD
- Kyley Mitchell, OD
- Sarah Morrison, PHARM D
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.