Individual provider Active NPI

Scott Leslie

  • Pharmacist
  • Maryville, TN
National Provider Identifier
1265043913
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10285 Issued in TN
Practice address
1810 Robert C Jackson Dr
Maryville, TN 37801-3788
Phone
(865) 982-9235
NPI assigned
Aug 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10285 TN Primary

Addresses

Primary practice location

1810 Robert C Jackson Dr
Maryville, TN 37801-3788

Mailing address

1600 Downtown West Blvd Ste J
Knoxville, TN 37919-5497

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

LicenseStateTypeSpecialty
10285TNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1265043913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 DOWNTOWN WEST BLVD STE J",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 ROBERT C JACKSON DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378013788",
            "telephone_number": "865-982-9235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-14",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "10285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.