NPIMap

Organization Active NPI

Phipps Pharmacy Inc

Doing business as Phipps Pharmacy, Huntingdon

  • Community/Retail Pharmacy
  • Huntingdon, TN
National Provider Identifier
1467091488
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PHIPPS PHARMACY INC
Doing business as
Phipps Pharmacy, Huntingdon
Practice address
20190 Main St E
Huntingdon, TN 38344-4119
Phone
(731) 352-0820
NPI assigned
Dec 23, 2019
Last updated
Dec 23, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PHIPPS PHARMACY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Authorized official

Name
Dr. Jerry Robert Phipps Jr., PHARMDNPI 1306049630
Title
President/Ceo
Phone
(731) 352-0820

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

20190 Main St E
Huntingdon, TN 38344-4119

Mailing address

205B Hospital Dr
MC Kenzie, TN 38201-1649
Phone (731) 352-0820

Other names 1

  • Phipps Pharmacy, Huntingdon Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201207001998 TN Part B Supplier - Mass Immunization (Roster Biller Only) 7719188978 Practice locations: Huntingdon, TN

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2209273Phipps Pharmacy, Huntingdon20190 Main Street E, Huntingdon, TN 38344Certificate of waiverJan 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Phipps Pharmacy Inc4 organizations share this tax ID, including this one
Part of
Phipps Pharmacy Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

20190 Main St E
Huntingdon, TN 38344
Phone (731) 352-0820

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1467091488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205B HOSPITAL DR",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20190 MAIN ST E",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383444119",
            "telephone_number": "731-352-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHIPPS PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHIPPS PHARMACY INC",
        "enumeration_date": "2019-12-23",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "PHIPPS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "731-352-0820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phipps Pharmacy, Huntingdon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntingdon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.