Joshua Ryne Blake

Primary specialty

PharmacistTaxonomy code 183500000X

License

36733 Issued in TN

Practice address

4210 N Roan St
Johnson City, TN 37601-1130

Phone

(423) 262-0201

Fax

(423) 262-0380

NPI assigned

Oct 18, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jeff City Pharmacist Group LLC Dba MD Pharmacy Store 2

  • Pharmacy
  • Jefferson City, TN
  • NPI 1073979522
  NPD Authorized official
• Walgreen Co.

  • Pharmacy
  • Johnson City, TN
  • NPI 1912131095
  NPD (past)

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1831442599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37601",
            "telephone_number": "423-262-0201",
            "fax_number": "423-262-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011130",
            "telephone_number": "423-262-0201",
            "fax_number": "423-262-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "JOSHUA",
        "middle_name": "RYNE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "36733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassie Shyanne Blackwell, FNP-C
• Julia Marie Blair, PHARMD
• Jonathan Blaise
• Barbara Blake
• Cathaleen Lynn Blake, M.A., LPC
• Heather Leanne-Crabtree Blakely, FNP-BC
• Cristi Lynn Blalock
• Jesse Blanchard
• Clay Blanchett, MD
• Aimee Gilliam Bland, RN

• Pharmacist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Pharmacist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.