Individual provider Active NPI

Blake C. Mishler, PHARMD

  • Pharmacist
  • Clarksville, TN
National Provider Identifier
1730456773
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13671-1 Issued in KS
Practice address
2444 Settlers Trce
Clarksville, TN 37043-1523
Phone
(303) 320-9415
NPI assigned
Nov 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 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 13671-1 KS Primary

Addresses

Primary practice location

2444 Settlers Trce
Clarksville, TN 37043-1523

Mailing address

2444 Settlers Trce
Clarksville, TN 37043-1523
Phone (303) 320-9415

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
13671-1KSMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1730456773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2444 SETTLERS TRCE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431523",
            "telephone_number": "303-320-9415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2444 SETTLERS TRCE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431523",
            "telephone_number": "303-320-9415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHLER",
        "first_name": "BLAKE",
        "middle_name": "C.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "13671-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 18, 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.