Mary Ann Roark, DPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

7478 Issued in TN

Practice address

19118 Alberta St
Oneida, TN 37841-6003

Phone

(423) 569-9000

Fax

(423) 569-2402

NPI assigned

Nov 14, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922170166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19118 ALBERTA ST",
            "city": "ONEIDA",
            "state": "TN",
            "postal_code": "378416003",
            "telephone_number": "423-569-9000",
            "fax_number": "423-569-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19118 ALBERTA ST",
            "city": "ONEIDA",
            "state": "TN",
            "postal_code": "378416003",
            "telephone_number": "423-569-9000",
            "fax_number": "423-569-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROARK",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "DPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "7478",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "010025",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS 19818",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LIC NUMBER",
            "identifier": "7478",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jodi Nichole Potter-Krahn
• Preferred Health Services of Tennessee, Inc. (Oneida Nursing & Rehab Center)
• PT Solutions LLC (PT Solutions of Oneida)
• PT Solutions, LLC
• Alexis Ramires
• Matthew R Roark, LPC
• Terry Roark, DPH
• Roark's Pharmacy Inc (Roark Clinical Services)
• Roark's Pharmacy Inc (Roark's Pharmacy Long Term Care)
• Roark's Pharmacy, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.