Individual provider Active NPI

Phouthavanh Savatphonh

  • Pharmacist
  • Clarksville, TN
National Provider Identifier
1437677929
Registry record updated Sep 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
41394 Issued in TN
Practice address
498 Warfield Blvd
Clarksville, TN 37043-6071
Phone
(931) 551-4290
NPI assigned
Sep 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 41394 TN Primary

Addresses

Primary practice location

498 Warfield Blvd
Clarksville, TN 37043-6071

Mailing address

200 Holland Dr # M1238
Clarksville, TN 37043-2545
Phone (615) 299-6563

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

LicenseStateTypeSpecialty
41394TNMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504569600000",
    "number": "1437677929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOLLAND DR # M1238",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370432545",
            "telephone_number": "615-299-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 WARFIELD BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436071",
            "telephone_number": "931-551-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAVATPHONH",
        "first_name": "PHOUTHAVANH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-05",
        "last_updated": "2017-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "41394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2017; 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.