Ryan Wagner Varnum

Primary specialty

PharmacistTaxonomy code 183500000X

License

45460 Issued in TN

Practice address

141 Town Centre Dr
Crossville, TN 38571-7997

Phone

(931) 484-1368

NPI assigned

Sep 8, 2021

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

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.

• K VA T Food Stores Inc

  • Community/Retail Pharmacy
  • Crossville, TN
  • NPI 1750553467
  NPD
• K VA T Food Stores Inc

  • Community/Retail Pharmacy
  • Huntsville, AL
  • NPI 1245038512
  NPD (past)

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1891464335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 LAKE HERITAGE WAY UNIT 305",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379225194",
            "telephone_number": "865-607-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 TOWN CENTRE DR",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385717997",
            "telephone_number": "931-484-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARNUM",
        "first_name": "RYAN",
        "middle_name": "WAGNER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "45460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Upper Cumberland Rural Health Clinic PLLC
• Shannon Brooke Van Horn, PHARMD
• Ronald James Varcak, D.O.
• Mallory Varner, MS, CCC-SLP
• Karen Varney
• Vascular Wellness Center Inc
• Victor a. Shada, D.O., P.C.
• Vianney Epina Villaruz, MD
• Adrian Vinas
• Jack Monroe Visca

• Pharmacist in Crossville, TN
• Providers in Crossville, TN by specialty
• Pharmacist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.