Keith Eugene Cloud, DPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

7575 Issued in TN

Practice address

15 Carters GRV
Jackson, TN 38305-1795

Phone

(731) 695-4536

NPI assigned

Jun 26, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1656201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656201600000",
    "number": "1467184853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CARTERS GRV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CARTERS GRV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051795",
            "telephone_number": "731-695-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUD",
        "first_name": "KEITH",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-26",
        "last_updated": "2022-06-26",
        "certification_date": "2022-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "7575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "keith.cloud@henderson.health",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "15 Carters Grv",
            "city": "Jackson",
            "state": "TN",
            "country_code": "US",
            "postal_code": "383051795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Jackson, TN
• Providers in Jackson, TN by specialty
• Pharmacist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2022; 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.