Active NPI
John T. Heatherly III, PHARM D.
- Pharmacist
- Sevierville, TN
National Provider Identifier
1851678155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12839
- Practice address
- 119 Forks of the River Pkwy
Sevierville, TN 37862-3435 - Phone
- (865) 908-8755
- NPI assigned
- Nov 15, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 12839 | TN | Primary |
Addresses
Primary practice location
119 Forks of the River Pkwy
Sevierville, TN 37862-3435
Mailing address
370 Elkins Rd
Jacksboro, TN 37757-2418
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 |
|---|---|---|---|
| 12839 | TN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321315200000",
"number": "1851678155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "370 ELKINS RD",
"city": "JACKSBORO",
"state": "TN",
"postal_code": "377572418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 FORKS OF THE RIVER PKWY",
"city": "SEVIERVILLE",
"state": "TN",
"postal_code": "378623435",
"telephone_number": "865-908-8755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEATHERLY",
"first_name": "JOHN",
"middle_name": "T.",
"name_suffix": "III",
"credential": "PHARM D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-15",
"last_updated": "2011-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "12839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sevierville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.