Active NPI
Shaloam Bryan, PHARM D.
- Pharmacist
- Rogersville, TN
National Provider Identifier
1730518705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0000033018
- Practice address
- 4331 Highway 66 S
Rogersville, TN 37857-3145 - Phone
- (423) 272-9393
- NPI assigned
- Nov 11, 2013
- 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 | 0000033018 | TN | Primary |
Addresses
Primary practice location
4331 Highway 66 S
Rogersville, TN 37857-3145
Mailing address
664 Prices Grove Rd
Rogersville, TN 37857-5806
Phone (423) 272-9393
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0000033018 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384128000000",
"number": "1730518705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "664 PRICES GROVE RD",
"city": "ROGERSVILLE",
"state": "TN",
"postal_code": "378575806",
"telephone_number": "423-272-9393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4331 HIGHWAY 66 S",
"city": "ROGERSVILLE",
"state": "TN",
"postal_code": "378573145",
"telephone_number": "423-272-9393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYAN",
"first_name": "SHALOAM",
"name_prefix": "Dr.",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-11",
"last_updated": "2013-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "0000033018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rogersville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.