Kerillos Gendy

Primary specialty

PharmacistTaxonomy code 183500000X

License

46501 Issued in TN

Practice address

2909 Murfreesboro Pike
Antioch, TN 37013-2227

Phone

(615) 366-4280

NPI assigned

May 12, 2023

Sex

Male

Sole proprietor

Yes

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

Locations

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.

• Walgreen Co

  • Pharmacy
  • Antioch, TN
  • NPI 1972510998
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1683849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1831889773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 ROCKGLADE RUN",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133077",
            "telephone_number": "615-627-6814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 MURFREESBORO PIKE",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370132227",
            "telephone_number": "615-366-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENDY",
        "first_name": "KERILLOS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "46501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ervin Garcia, FNP-BC
• Jessica Elizabeth Garnea, MD
• Erin Mackay Gatgens, LPT, DPT
• Fasika Getahun Gebremariam, CERTIFICATE
• Feson Gebremedhin
• Gentle Hands Home Health Care Service
• Genx Investments LLC
• George Ruccio
• Eman George
• Michael Graves Gerard, RN

• All providers in Antioch, TN
• Pharmacist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.

Verify at the official NPI Registry.