NPIMap

Organization Active NPI

Walker & Wyatt, LLC

  • Pharmacy
  • Maryville, TN
National Provider Identifier
1659830701
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
WALKER & WYATT, LLC
Practice address
2541 E Broadway Ave
Maryville, TN 37804-2760
Phone
(865) 983-9591
Fax
(865) 983-6632
NPI assigned
Mar 18, 2019
Organization subpart
Yes
Parent organization
WALKER & WYATT, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Lisa Jane Lawson, PHARM.DNPI 1841327830
Title
Owner/Manager
Phone
(865) 579-4547

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 183500000X
Pharmacy 333600000X Primary

Addresses

Primary practice location

2541 E Broadway Ave
Maryville, TN 37804-2760

Mailing address

2541 E Broadway Ave
Maryville, TN 37804-2760
Phone (865) 983-9591

Other identifiers 1

IdentifierTypeStateIssuer
Q046535MedicaidTN

Other names 1

  • Village Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210208001596 TN Part B Supplier - Pharmacy 4183718919 Practice locations: Maryville, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
The Medicine Shoppe

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1659830701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2541 E BROADWAY AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378042760",
            "telephone_number": "865-983-9591",
            "fax_number": "865-983-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2541 E BROADWAY AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378042760",
            "telephone_number": "865-983-9591",
            "fax_number": "865-983-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALKER & WYATT, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALKER & WYATT, LLC",
        "enumeration_date": "2019-03-18",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "865-579-4547",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q046535",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.