NPIMap

Organization Active NPI

Centerstone Pharmacy

  • Long Term Care Pharmacy
  • Clarksville, TN
National Provider Identifier
1861898512
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
CENTERSTONE PHARMACY
Doing business as
Centerstone Pharmacy
Practice address
511 8TH St
Clarksville, TN 37040-3093
Phone
(931) 920-7252
NPI assigned
Nov 7, 2014
Last updated
Jul 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Authorized official

Name
Keith Shelly
Title
Director of Pharmacy
Phone
(615) 294-4857

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

511 8TH St
Clarksville, TN 37040-3093

Mailing address

511 8TH St
Clarksville, TN 37040-3093
Phone (931) 920-7252

Other identifiers 1

IdentifierTypeStateIssuer
2148611OtherPK

Other names 1

  • Centerstone Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201229000900 TN Part B Supplier - Mass Immunization (Roster Biller Only) 9739088113 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Nashville, TN; Madison, TN; Clarksville, TN

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Centerstone of Tennessee in27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1861898512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 8TH ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403093",
            "telephone_number": "931-920-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 8TH ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403093",
            "telephone_number": "931-920-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERSTONE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-07",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "SHELLY",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "615-294-4857"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148611",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centerstone Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Centerstone Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.