Active NPI
Cheryl A Reardon, DPH, CDE
- Pharmacist
- Johnson City, TN
National Provider Identifier
1366565160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3919
- Practice address
- 525 N State of Franklin Rd
Johnson City, TN 37604-8213 - Phone
- (423) 926-6154
- Fax
- (423) 926-5571
- NPI assigned
- Apr 8, 2007
- Sex
- Female
- 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 | 3919 | TN | Primary |
Addresses
Primary practice location
525 N State of Franklin Rd
Johnson City, TN 37604-8213
Mailing address
807 Xanadu CT
Johnson City, TN 37604-3095
Phone (423) 282-4500
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 |
|---|---|---|---|
| 3919 | TN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366565160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 XANADU CT",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376043095",
"telephone_number": "423-282-4500",
"fax_number": "423-926-5571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 N STATE OF FRANKLIN RD",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376048213",
"telephone_number": "423-926-6154",
"fax_number": "423-926-5571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARDON",
"first_name": "CHERYL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DPH, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "3919",
"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 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.