Individual provider Active NPI

Stephanie Michelle Matney, RPH

  • Pharmacist
  • Bristol, TN
National Provider Identifier
1861995516
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9201 Issued in TN
Practice address
220 Century Blvd
Bristol, TN 37620-6721
Phone
(423) 968-9559
NPI assigned
Mar 8, 2018
Last updated
Mar 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 9201 TN Primary

Addresses

Primary practice location

220 Century Blvd
Bristol, TN 37620-6721

Mailing address

220 Century Blvd
Bristol, TN 37620-6721
Phone (423) 968-9559

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
9201TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1861995516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CENTURY BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376206721",
            "telephone_number": "423-968-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 CENTURY BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376206721",
            "telephone_number": "423-968-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATNEY",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "9201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; 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.