JJ Beans at Mossy Creek LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

JJ BEANS AT MOSSY CREEK LLC

Practice address

1404 S Sizer Ave Ste a
Jefferson City, TN 37760-2411

Phone

(423) 586-0721

NPI assigned

May 22, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Chad Huntsman, PHARMD

Title

Managing Member

Phone

(423) 586-0721

Specialties & licenses 1

Addresses

Other names 1

• Mossy Creek Pharmacy Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1619669397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 E ANDREW JOHNSON HWY",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378145412",
            "telephone_number": "423-586-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 S SIZER AVE STE A",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602411",
            "telephone_number": "423-586-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JJ BEANS AT MOSSY CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "HUNTSMAN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "423-586-0721",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mossy Creek Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Jefferson City, TN
• Providers in Jefferson City, TN by specialty
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.