Active NPI
Cheryl Shelnutt
- Community/Retail Pharmacy
- Johnson City, TN
National Provider Identifier
1346004157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 10616
- Practice address
- 1888 Old Boones Creek Rd
Johnson City, TN 37615-4428 - Phone
- (865) 250-7752
- NPI assigned
- Feb 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 10616 | TN | |
| Pharmacotherapy Pharmacist | 1835P1200X | 10616 | TN | |
| Home Infusion Therapy Pharmacy | 3336H0001X | |||
| Community/Retail Pharmacy | 3336C0003X | 10616 | TN | Primary |
Addresses
Primary practice location
1888 Old Boones Creek Rd
Johnson City, TN 37615-4428
Mailing address
1888 Old Boones Creek Rd
Johnson City, TN 37615-4428
Phone (865) 250-7752
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 |
|---|---|---|---|
| 10616 | TN | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707696000000",
"number": "1346004157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1888 OLD BOONES CREEK RD",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376154428",
"telephone_number": "865-250-7752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1888 OLD BOONES CREEK RD",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376154428",
"telephone_number": "865-250-7752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELNUTT",
"first_name": "CHERYL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-12",
"last_updated": "2024-02-12",
"certification_date": "2024-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "TN",
"license": "10616",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "TN",
"license": "10616",
"primary": false
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TN",
"license": "10616",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.