Active NPI
Robert Owen Henderson Jr., DRPH
- Pharmacist
- Jackson, TN
National Provider Identifier
1649581430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6225
- Practice address
- 384 Oil Well Rd
Jackson, TN 38305-7929 - Phone
- (731) 664-8892
- Fax
- (731) 664-9195
- NPI assigned
- Jun 25, 2010
- Last updated
- Jun 25, 2010
- 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 | 6225 | TN | Primary |
Addresses
Primary practice location
384 Oil Well Rd
Jackson, TN 38305-7929
Mailing address
384 Oil Well Rd
Jackson, TN 38305-7929
Phone (731) 664-8892
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063429082 | Other | TN | NPI #WALGREENS STORE 9835 |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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": "1277424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277424000000",
"number": "1649581430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "384 OIL WELL RD",
"city": "JACKSON",
"state": "TN",
"postal_code": "383057929",
"telephone_number": "731-664-8892",
"fax_number": "731-664-9195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "384 OIL WELL RD",
"city": "JACKSON",
"state": "TN",
"postal_code": "383057929",
"telephone_number": "731-664-8892",
"fax_number": "731-664-9195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "ROBERT",
"middle_name": "OWEN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DRPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-25",
"last_updated": "2010-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "6225",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI #WALGREENS STORE 9835",
"identifier": "1063429082",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, TN
- Helping Hands of Middle & West Tennessee (Helping Hands of Tennessee)
- Helping Hands of Middle & West Tennessee (Helping Hands of Tennessee)
- Amanda Jane Helton-Clark, PHARMD
- Hematology Oncology Associates, PC
- Jennifer Hartwell Henderson, M.A. CCC-SLP
- Denean Hendren, APN
- Kenzie Britt Hendrix, DO
- Haley Henley, LMSW
- Scarlett P Henley, CMHC
- Taylor Madison Henley, APRN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.