Individual provider Active NPI

Philip Scott Johnson, PHARMD

  • Pharmacist
  • Cedar Bluff, VA
National Provider Identifier
1508202854
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202012259 Issued in VA
Practice address
1051 Claypool Hill Mall Rd Ste 1
Cedar Bluff, VA 24609-8201
Phone
(276) 963-1067
Fax
(276) 964-6344
NPI assigned
May 14, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202012259 VA Primary

Addresses

Primary practice location

1051 Claypool Hill Mall Rd Ste 1
Cedar Bluff, VA 24609-8201

Mailing address

1 Claypool Hill Mall
Cedar Bluff, VA 24609
Phone (276) 963-1067

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0202012259VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1508202854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CLAYPOOL HILL MALL",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "24609",
            "telephone_number": "276-963-1067",
            "fax_number": "276-964-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 CLAYPOOL HILL MALL RD STE 1",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246098201",
            "telephone_number": "276-963-1067",
            "fax_number": "276-964-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PHILIP",
        "middle_name": "SCOTT",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202012259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Bluff, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.