Active NPI
I. Shane Trent, PHARMD, MBA
- Pharmacist
- Greeneville, TN
National Provider Identifier
1770637076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11200
- Practice address
- 1420 Tusculum Blvd
Laughlin Memorial Hospital
Greeneville, TN 37745-4279 - Phone
- (423) 787-5065
- Fax
- (423) 787-5067
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 11200 | TN | Primary |
Addresses
Primary practice location
1420 Tusculum Blvd
Laughlin Memorial Hospital
Greeneville, TN 37745-4279
Mailing address
474 Old Embreeville Rd
Jonesborough, TN 37659-6175
Phone (423) 327-4702
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
- Master of Business Administration, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11200 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770637076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "474 OLD EMBREEVILLE RD",
"city": "JONESBOROUGH",
"state": "TN",
"postal_code": "376596175",
"telephone_number": "423-327-4702",
"fax_number": "423-787-5067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 TUSCULUM BLVD",
"address_2": "LAUGHLIN MEMORIAL HOSPITAL",
"city": "GREENEVILLE",
"state": "TN",
"postal_code": "377454279",
"telephone_number": "423-787-5065",
"fax_number": "423-787-5067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRENT",
"first_name": "I.",
"middle_name": "SHANE",
"name_prefix": "Dr.",
"credential": "PHARMD, MBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "11200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greeneville, 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.