Active NPI
Timothy London Archibald, PHARMD
- Pharmacist
- Johnson City, TN
National Provider Identifier
1396343380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 44133
- Practice address
- 2240 N Roan St
Johnson City, TN 37601-2521 - Phone
- (423) 283-4942
- NPI assigned
- Oct 13, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 44133 | TN | Primary |
Addresses
Primary practice location
2240 N Roan St
Johnson City, TN 37601-2521
Mailing address
2015 Williamsburg SQ
Johnson City, TN 37604-7765
Phone (423) 747-4720
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
| License | State | Type | Specialty |
|---|---|---|---|
| 44133 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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": "1602547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602547200000",
"number": "1396343380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2015 WILLIAMSBURG SQ",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376047765",
"telephone_number": "423-747-4720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2240 N ROAN ST",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376012521",
"telephone_number": "423-283-4942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCHIBALD",
"first_name": "TIMOTHY",
"middle_name": "LONDON",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-13",
"last_updated": "2020-10-13",
"certification_date": "2020-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "TN",
"license": "44133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
- Appalachian Radiation Oncology Associates, P. C.
- Appalchain Skin and Lasar Dba Ageless Skin and Laser
- Madison Nichole Appleba, LCSW
- Applegate Health Services of Tennessee, Inc. (AppleGate Recovery Johnson City)
- Kristen Medlock Archibald, PHARMD
- Kalene Ardt
- Daniel P Armentrout, MD
- Amanda L Armstong, MSW
- Ronnie Jo Armstrong, RDN
- Rachael L Arnett, BA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.