NPIMap

Organization Active NPI

Ingles Markets Inc

  • Community/Retail Pharmacy
  • Jonesborough, TN
National Provider Identifier
1912912866
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
INGLES MARKETS INC
Practice address
1200 W Jackson Blvd
Jonesborough, TN 37659-5294
Phone
(423) 753-9730
Fax
(423) 753-4326
NPI assigned
Jul 29, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Stephen V Cucchi, RPH
Title
VP of Pharmacy
Phone
(828) 669-2941

Other NPIs on the same Medicare enrollment 10

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

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2184851Ingles Markets, Inc (Ingles Pharmacy #398)1200 W Jackson Blvd, Jonesborough, TN 37659Certificate of waiverMay 25, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ingles Markets Pharmacy #3981200 W Jackson Blvd, Jonesborough, TN 37659-5294(423) 753-9730 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Sep 24, 2024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090914000457 TN Part B Supplier - Mass Immunization (Roster Biller Only) 5092867614 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jonesborough, TN; Powell, TN; Morristown, TN; Lenoir City, TN; Knoxville, TN; Kingsport, TN; Johnson City, TN; Greeneville, TN…
O20100930031813 TN DME Supplier - PharmacyDME Supplier - Grocery Store 5092867614 Practice locations: Jonesborough, TN

National Provider Directory

National Provider Directory

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 4001 TN
Community/Retail Pharmacy 3336C0003X Primary

Addresses

NPPES NPI Registry

Primary practice location

1200 W Jackson Blvd
Jonesborough, TN 37659-5294

Mailing address

PO Box 603941
Charlotte, NC 28260-3941
Phone (828) 669-2941

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
4437326MedicaidTN
4437326OtherOTHER ID NUMBER-COMMERCIAL NUMBER
P00955035OtherMEDICARE RAILROAD

Other names 1

NPPES NPI Registry
  • INGLES PHARMACY #398 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 15, 2019.

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565827200000",
    "number": "1912912866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603941",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603941",
            "telephone_number": "828-669-2941",
            "fax_number": "828-669-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W JACKSON BLVD",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376595294",
            "telephone_number": "423-753-9730",
            "fax_number": "423-753-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGLES MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2019-08-15",
        "status": "A",
        "authorized_official_last_name": "CUCCHI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "VP OF PHARMACY",
        "authorized_official_telephone_number": "828-669-2941",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "4001",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4437326",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4437326",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00955035",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INGLES PHARMACY #398",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "INGLES PHARMACY #398",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesborough, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.