Integration Partners LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

INTEGRATION PARTNERS LLC

Practice address

535 W Main St
Henderson, TN 38340-2536

Phone

(731) 989-0077

Fax

(731) 989-0076

NPI assigned

Oct 21, 2019

Organization subpart

No

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

Authorized official

Name

Mark DearthNPI 1205189487

Title

Owner/Pharmd

Phone

(731) 695-0342

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Henderson Family Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Tax ID family

Integration Partners LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Integration Partners LLC

  • Long Term Care Pharmacy
  • Henderson, TN
  • NPI 1518667120
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Integration Partners LLC

  • Long Term Care Pharmacy
  • Henderson, TN
  • NPI 1518667120
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Dearth

  • Pharmacist
  • Henderson, TN
  • NPI 1205189487
  NPD Authorized official

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1306489554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 W MAIN ST",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383402536",
            "telephone_number": "731-989-0077",
            "fax_number": "731-989-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W MAIN ST",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383402536",
            "telephone_number": "731-989-0077",
            "fax_number": "731-989-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATION PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-21",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "DEARTH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/PHARMD",
        "authorized_official_telephone_number": "731-695-0342"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q054737",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henderson Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henderson Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Thomas Hinson, OTR/L
• Mindy Raines Hopper, LCSW
• Kennan Jaron Huddleston
• Jamie P Hurst, BS
• Jeremy Jerome Hurst, PTA
• Integration Partners LLC
• Gary Mitchell Irwin Jr., FNP-C
• Diane G Jeffries, LPC
• Nicole Michelle Jennings, M.D.
• Karen Nicole Johnson, OD

• All providers in Henderson, TN
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.