Individual provider Active NPI

Philip Blake Musick, PHARMD.

  • Pharmacist
  • Knoxville, TN
National Provider Identifier
1811270242
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
35734 Issued in TN
Practice address
148 Legacy View Way
Knoxville, TN 37918-8230
Phone
(865) 444-6207
NPI assigned
Sep 22, 2011
Last updated
Feb 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 35734 TN Primary

Addresses

Primary practice location

148 Legacy View Way
Knoxville, TN 37918-8230

Mailing address

2408 Susannah St Ste 3
Johnson City, TN 37601-1765
Phone (423) 202-7870

Other practice location 1

3900 Fort Henry Dr
Kingsport, TN 37663-2026
Phone (423) 239-6845

Other identifiers 1

IdentifierTypeStateIssuer
Q048083MedicaidTN

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

Practice roles

OrganizationSpecialtyStatusNew patients
LW Pharmaceuticals Inc Current Accepting new patients
Life Well Pharmacy, LLC CurrentSince Sep 1, 2021 Accepting new patients
Life Well Pharmacy, LLC CurrentSince Jun 21, 2020 Accepting new patients
Life Well Pharmacy, LLC CurrentSince Feb 25, 2024 Accepting new patients
LW Pharmaceuticals Inc Current Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Locations

2408 Susannah St
Ste 3
Johnson City, TN 37601
Phone (423) 202-7870

148 Legacy View Way
Knoxville, TN 37918
Phone (865) 444-6207

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1811270242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 SUSANNAH ST STE 3",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011765",
            "telephone_number": "423-202-7870",
            "fax_number": "232-682-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 LEGACY VIEW WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379188230",
            "telephone_number": "865-444-6207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Fort Henry Dr",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376632026",
            "country_code": "US",
            "telephone_number": "423-239-6845",
            "fax_number": "423-239-6610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSICK",
        "first_name": "PHILIP",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "PHARMD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-22",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "35734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q048083",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.