Individual provider Active NPI

Anthony Lamar Evans, PHARM-D

  • Pharmacist
  • Red Bank, TN
National Provider Identifier
1407136401
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
TN11978 Issued in TN
Practice address
3901 Dayton Blvd
Red Bank, TN 37415-2715
Phone
(423) 877-9516
Fax
(423) 877-9458
NPI assigned
Aug 22, 2011
Last updated
Aug 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5421 SC
Pharmacist 183500000X TN11978 TN Primary

Addresses

Primary practice location

3901 Dayton Blvd
Red Bank, TN 37415-2715

Mailing address

3901 Dayton Blvd
Red Bank, TN 37415-2715
Phone (423) 877-9516

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
TN11978TNMDPharmacist
5421SCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1407136401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 DAYTON BLVD",
            "city": "RED BANK",
            "state": "TN",
            "postal_code": "374152715",
            "telephone_number": "423-877-9516",
            "fax_number": "423-877-9458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 DAYTON BLVD",
            "city": "RED BANK",
            "state": "TN",
            "postal_code": "374152715",
            "telephone_number": "423-877-9516",
            "fax_number": "423-877-9458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ANTHONY",
        "middle_name": "LAMAR",
        "name_prefix": "Mr.",
        "credential": "PHARM-D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-22",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "5421",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "TN11978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.