Individual provider Active NPI

Jordan Shea Goetzke, PHARM.D.

  • Pharmacist
  • Franklin, TN
National Provider Identifier
1386926988
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
34564 Issued in TN
Practice address
9100 Carothers Pkwy
Franklin, TN 37067-6300
Phone
(615) 771-6446
Fax
(615) 771-9474
NPI assigned
Sep 9, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 34564 TN Primary

Addresses

Primary practice location

9100 Carothers Pkwy
Franklin, TN 37067-6300

Mailing address

9100 Carothers Pkwy
Franklin, TN 37067-6300
Phone (615) 771-6446

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
34564TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1386926988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 CAROTHERS PKWY",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676300",
            "telephone_number": "615-771-6446",
            "fax_number": "615-771-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 CAROTHERS PKWY",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676300",
            "telephone_number": "615-771-6446",
            "fax_number": "615-771-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETZKE",
        "first_name": "JORDAN",
        "middle_name": "SHEA",
        "name_prefix": "Mr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-09",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "34564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.