Kendle Dwayne Davidson

Primary specialty

PharmacistTaxonomy code 183500000X

License

3783 Issued in TN

Practice address

110 Hillcrest Dr
Byrdstown, TN 38549-2323

Phone

(931) 864-3166

Fax

(931) 864-8166

NPI assigned

Jun 17, 2015

Last updated

Jun 17, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Davidsons Discount Drugs Inc

  • Community/Retail Pharmacy
  • Byrdstown, TN
  • NPI 1912928979
  NPD

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1467833111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HILLCREST DR",
            "city": "BYRDSTOWN",
            "state": "TN",
            "postal_code": "385492323",
            "telephone_number": "931-864-3166",
            "fax_number": "931-864-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HILLCREST DR",
            "city": "BYRDSTOWN",
            "state": "TN",
            "postal_code": "385492323",
            "telephone_number": "931-864-3166",
            "fax_number": "931-864-8166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "KENDLE",
        "middle_name": "DWAYNE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "3783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Mae Beaty, CNA
• Clearwater Investments Inc Byrdstown Medical (Byrdstown Medical)
• Amanda Collier
• Cullen Cleveland Copeland Sr., MD
• Helen Amber Davidson
• Davidsons Discount Drugs Inc
• Brooke Ann Dowdy, FNP-C
• Firstchoice Family Care
• Firstchoice Family Care
• Rachel Force

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; 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.