Active NPI
Rhonda Boutte, PHARM.D
- Pharmacist
- Memphis, TN
National Provider Identifier
1922371657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29520
- Practice address
- 4155 Highway 61 South
Memphis, TN 38109 - Phone
- (901) 785-6851
- NPI assigned
- Feb 10, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 29520 | TN | Primary |
Addresses
Primary practice location
4155 Highway 61 South
Memphis, TN 38109
Mailing address
4155 Highway 61 South
Memphis, TN 38109
Phone (901) 785-6851
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29520 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328832000000",
"number": "1922371657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4155 HIGHWAY 61 SOUTH",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38109",
"telephone_number": "901-785-6851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4155 HIGHWAY 61 SOUTH",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38109",
"telephone_number": "901-785-6851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUTTE",
"first_name": "RHONDA",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-10",
"last_updated": "2012-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "29520",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.