Active NPI
Marc Wattenbarger
- Pharmacist
- Sweetwater, TN
National Provider Identifier
1417270638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11745
- Practice address
- 902 S Main St
Sweetwater, TN 37874-1829 - Phone
- (423) 337-2829
- NPI assigned
- Mar 2, 2010
- Last updated
- Mar 2, 2010
- 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 | 11745 | TN | Primary |
Addresses
Primary practice location
902 S Main St
Sweetwater, TN 37874-1829
Mailing address
902 S Main St
Sweetwater, TN 37874-1829
Phone (423) 337-2829
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11745 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267488000000",
"number": "1417270638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 S MAIN ST",
"city": "SWEETWATER",
"state": "TN",
"postal_code": "378741829",
"telephone_number": "423-337-2829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 S MAIN ST",
"city": "SWEETWATER",
"state": "TN",
"postal_code": "378741829",
"telephone_number": "423-337-2829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTENBARGER",
"first_name": "MARC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-02",
"last_updated": "2010-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "11745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sweetwater, TN
- Chloe Ann Vincil, LPC-MHSP, NCC
- Wal-Mart Stores East LP (WalMart Pharmacy 10-4166)
- Wal-Mart Stores East, LP (Wal-Mart Vision Center 30-4166)
- Walgreen Co (Walgreens #10066)
- Waters of Sweetwater a Rehabilitation & Nursing Center LLC
- Brenda P Watts, RPH
- John Watts Jr., R. PH
- Christina L Weber, MD
- Mark J Wegzyn, D.D.S.
- Hannah Marie Wells, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.