Active NPI
Roger Alan Teague
- Pharmacist
- Clarksville, TN
National Provider Identifier
1669970281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5389
- Practice address
- 3315 Guthrie Hwy
Clarksville, TN 37040-5507 - Phone
- (931) 552-4602
- Fax
- (931) 552-4715
- NPI assigned
- Jan 29, 2018
- 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 | 5389 | TN | Primary |
Addresses
Primary practice location
3315 Guthrie Hwy
Clarksville, TN 37040-5507
Mailing address
3315 Guthrie Hwy
Clarksville, TN 37040-5507
Phone (931) 552-4602
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 593872 | Other | TN | NABP |
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 |
|---|---|---|---|
| 5389 | TN | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517184000000",
"number": "1669970281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3315 GUTHRIE HWY",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370405507",
"telephone_number": "931-552-4602",
"fax_number": "931-552-4715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3315 GUTHRIE HWY",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370405507",
"telephone_number": "931-552-4602",
"fax_number": "931-552-4715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEAGUE",
"first_name": "ROGER",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-29",
"last_updated": "2018-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "5389",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "593872",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.