John W Knoop, RPH – Pharmacist in Shively, KY

Key facts

NPI: 1790076545
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 07561 (KY)
Practice address: 4721 Dixie Hwy
Shively, KY 40216-2654
Phone: (502) 447-6550
Fax: (502) 447-1184
NPI assigned: Apr 27, 2011
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Registered Pharmacist

State licenses

License	State	Type	Specialty
07561	KY	MD	Pharmacist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	07561	KY	Yes

Addresses

Primary practice location

4721 Dixie Hwy
Shively, KY 40216-2654

Mailing address

4721 Dixie Hwy
Shively, KY 40216-2654
Phone (502) 447-6550

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 27, 2011.

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1790076545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 DIXIE HWY",
            "city": "SHIVELY",
            "state": "KY",
            "postal_code": "402162654",
            "telephone_number": "502-447-6550",
            "fax_number": "502-447-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4721 DIXIE HWY",
            "city": "SHIVELY",
            "state": "KY",
            "postal_code": "402162654",
            "telephone_number": "502-447-6550",
            "fax_number": "502-447-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOOP",
        "first_name": "JOHN",
        "middle_name": "W",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "07561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shively, KY

All providers in Shively, KY · Pharmacist in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.