Individual provider Active NPI

Larry David Lauke, RPH

  • Pharmacist
  • Smithville, TN
National Provider Identifier
1679871933
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
30162 Issued in TN
Practice address
703 S Congress Blvd
Smithville, TN 37166-2019
Phone
(615) 597-4200
Fax
(615) 597-7003
NPI assigned
Mar 9, 2011
Last updated
Mar 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 30162 TN Primary

Addresses

Primary practice location

703 S Congress Blvd
Smithville, TN 37166-2019

Mailing address

703 S Congress Blvd
Smithville, TN 37166-2019
Phone (615) 597-4200

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
30162TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1679871933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 S CONGRESS BLVD",
            "city": "SMITHVILLE",
            "state": "TN",
            "postal_code": "371662019",
            "telephone_number": "615-597-4200",
            "fax_number": "615-597-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 S CONGRESS BLVD",
            "city": "SMITHVILLE",
            "state": "TN",
            "postal_code": "371662019",
            "telephone_number": "615-597-4200",
            "fax_number": "615-597-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUKE",
        "first_name": "LARRY",
        "middle_name": "DAVID",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-09",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "30162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.