Active NPI
Carrie Keobounruang, PHARMD
- Pharmacist
- Germantown, TN
National Provider Identifier
1790482586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 46587
- Practice address
- 9325 Poplar Ave
Germantown, TN 38138-7906 - Phone
- (901) 309-1609
- NPI assigned
- Feb 13, 2023
- Sex
- Female
- 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 | 46587 | TN | Primary |
Addresses
Primary practice location
9325 Poplar Ave
Germantown, TN 38138-7906
Mailing address
8865 Briarwood CV
Cordova, TN 38018-6902
Phone (901) 512-7634
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 |
|---|---|---|---|
| 46587 | TN | MD | Pediatric Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1790482586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8865 BRIARWOOD CV",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380186902",
"telephone_number": "901-512-7634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9325 POPLAR AVE",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381387906",
"telephone_number": "901-309-1609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEOBOUNRUANG",
"first_name": "CARRIE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-13",
"last_updated": "2023-02-13",
"certification_date": "2023-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "46587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Germantown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.