Active NPI
Douglas Michael Bushong, RPH
- Pharmacist
- Erwin, TN
National Provider Identifier
1609208883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9957
- Practice address
- 109 N Main Ave
Erwin, TN 37650-1255 - Phone
- (423) 743-7105
- NPI assigned
- Jul 30, 2013
- Last updated
- Jul 30, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9957 | TN | Primary |
Addresses
Primary practice location
109 N Main Ave
Erwin, TN 37650-1255
Mailing address
1511 Kings Row
Johnson City, TN 37604-3642
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
- Registered Pharmacist
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roller Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375142400000",
"number": "1609208883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1511 KINGS ROW",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376043642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 N MAIN AVE",
"city": "ERWIN",
"state": "TN",
"postal_code": "376501255",
"telephone_number": "423-743-7105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSHONG",
"first_name": "DOUGLAS",
"middle_name": "MICHAEL",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-30",
"last_updated": "2013-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "9957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erwin, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.