Individual provider Active NPI

Anthony David Matney, PHARM D.

  • Pharmacist
  • Bristol, TN
National Provider Identifier
1700973534
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0000032939 Issued in TN
Practice address
1430 Volunteer Pkwy
Bristol, TN 37620-6067
Phone
(423) 968-2222
NPI assigned
Oct 5, 2006
Last updated
Dec 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202207106 VA
Pharmacist 183500000X 0000032939 TN Primary

Addresses

Primary practice location

1430 Volunteer Pkwy
Bristol, TN 37620-6067

Mailing address

1046 Deer Harbour Rd
Bristol, TN 37620-6520
Phone (423) 202-0452

Other practice location 1

18765 Riverside Dr.
Vansant, VA 24656
Phone (276) 935-7455

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0000032939TNMDPharmacist
0202207106VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
K VA T Food Stores Inc PastSince Dec 6, 2020 Accepting new patients
K VA T Food Stores Inc PastSince Dec 6, 2020 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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1700973534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 DEER HARBOUR RD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376206520",
            "telephone_number": "423-202-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 VOLUNTEER PKWY",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376206067",
            "telephone_number": "423-968-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18765 Riverside Dr.",
            "address_purpose": "LOCATION",
            "city": "Vansant",
            "state": "VA",
            "postal_code": "24656",
            "country_code": "US",
            "telephone_number": "276-935-7455",
            "fax_number": "276-935-7713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATNEY",
        "first_name": "ANTHONY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202207106",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "0000032939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.