Active NPI
Terry L Roller, D.PH.
- Pharmacist
- Erwin, TN
National Provider Identifier
1619089984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1406
- Practice address
- 109 N Main Ave
Erwin, TN 37650-1255 - Phone
- (423) 743-7105
- Fax
- (423) 743-7167
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 1406 | TN | Primary |
Addresses
Primary practice location
109 N Main Ave
Erwin, TN 37650-1255
Mailing address
109 N Main Ave
Erwin, TN 37650-1255
Phone (423) 743-7105
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3514702 | Medicaid | TN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1406 | TN | MD | Physical Medicine & Rehabilitation Physician |
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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Erwin, TN
- NPI 1922137702
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1619089984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 N MAIN AVE",
"city": "ERWIN",
"state": "TN",
"postal_code": "376501255",
"telephone_number": "423-743-7105",
"fax_number": "423-743-7167"
},
{
"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",
"fax_number": "423-743-7167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLLER",
"first_name": "TERRY",
"middle_name": "L",
"credential": "D.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "1406",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3514702",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Erwin, TN
- Rita Jean Richardson, MED LPCMHSP
- Jessica Megan Ritchie, PMHNP
- RJR Properties, PLLC
- Roller Pharmacy Inc
- Kendra Nicole Roller, PHARM.D.
- Christa Rosier, CCC, SLP
- Rural Health Services Consortium of Upper East Tennessee Inc
- Rebecca Sacora, M.D.
- Marc Winter Schlemmer, RPH
- Jacqui Renee Schollenberger, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.