Individual provider Active NPI

Michael Amos Stepp, PHARMACIST

  • Pharmacist
  • Jonesborough, TN
National Provider Identifier
1689706939
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
C5662 Issued in TN
Practice address
500 Forest Dr
Jonesborough, TN 37659-1510
Phone
(423) 753-3468
Fax
(423) 753-4274
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X C5662 TN Primary

Addresses

Primary practice location

500 Forest Dr
Jonesborough, TN 37659-1510

Mailing address

101 Highland Ridge CT
Johnson City, TN 37615-4498
Phone (423) 753-6664

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

LicenseStateTypeSpecialty
C5662TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
K-VA-T Food Stores Inc Past Accepting new patients
K VA T Food Stores Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689706939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HIGHLAND RIDGE CT",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154498",
            "telephone_number": "423-753-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FOREST DR",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376591510",
            "telephone_number": "423-753-3468",
            "fax_number": "423-753-4274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPP",
        "first_name": "MICHAEL",
        "middle_name": "AMOS",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "C5662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesborough, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.