Individual provider Active NPI

Michael E Stinnett, RPH

  • Pharmacist
  • Portland, TN
National Provider Identifier
1376752220
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
011957 Issued in KY
Practice address
705 S Broadway St
Portland, TN 37148-1628
Phone
(270) 842-4515
Fax
(270) 901-0187
NPI assigned
May 21, 2007
Last updated
Jan 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 011957 KY Primary

Addresses

Primary practice location

705 S Broadway St
Portland, TN 37148-1628

Mailing address

PO Box 1884
Bowling Green, KY 42102-1884
Phone (270) 392-4248

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
011957KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Prescription Shop PLLC Current Accepting new patients
Brown Pharmacy, LLC Current Accepting new patients

Locations

705 S Broadway St
Portland, TN 37148
Phone (615) 323-5050

Organizations & group practices 2

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1376752220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1884",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421021884",
            "telephone_number": "270-392-4248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S BROADWAY ST",
            "city": "PORTLAND",
            "state": "TN",
            "postal_code": "371481628",
            "telephone_number": "270-842-4515",
            "fax_number": "270-901-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINNETT",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "011957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.