Individual provider Active NPI

Shelly Joy Lewis, R.PH.

  • Pharmacist
  • Greeneville, TN
National Provider Identifier
1376779975
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
29333 Issued in TN
Practice address
1402 Tusculum Blvd
Greeneville, TN 37745-4279
Phone
(423) 588-5099
Fax
(423) 588-5935
NPI assigned
Jun 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 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 29333 TN Primary

Addresses

Primary practice location

1402 Tusculum Blvd
Greeneville, TN 37745-4279

Mailing address

1402 Tusculum Blvd
Greeneville, TN 37745-4279
Phone (423) 588-5099

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
29333TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Pharmacy of Greeneville CurrentSince Nov 22, 2020 Accepting new patients

Locations

1402 Tusculum Blvd
Greeneville, TN 37745
Phone (423) 588-5099

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1376779975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 TUSCULUM BLVD",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454279",
            "telephone_number": "423-588-5099",
            "fax_number": "423-588-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 TUSCULUM BLVD",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454279",
            "telephone_number": "423-588-5099",
            "fax_number": "423-588-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SHELLY",
        "middle_name": "JOY",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-09",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "29333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.