Active NPI
Koffi Amegbo Amegadje
- Pharmacist
- La Vergne, TN
National Provider Identifier
1922690635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 44887
- Practice address
- 5202 Murfreesboro Rd
La Vergne, TN 37086-2714 - Phone
- (615) 793-3784
- NPI assigned
- Feb 4, 2021
- Last updated
- Feb 4, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | 44887 | TN | Primary |
Addresses
Primary practice location
5202 Murfreesboro Rd
La Vergne, TN 37086-2714
Mailing address
5202 Murfreesboro Rd
La Vergne, TN 37086-2714
Phone (615) 793-3784
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44887 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612396800000",
"number": "1922690635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5202 MURFREESBORO RD",
"city": "LA VERGNE",
"state": "TN",
"postal_code": "370862714",
"telephone_number": "615-793-3784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5202 MURFREESBORO RD",
"city": "LA VERGNE",
"state": "TN",
"postal_code": "370862714",
"telephone_number": "615-793-3784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMEGADJE",
"first_name": "KOFFI",
"middle_name": "AMEGBO",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-02-04",
"last_updated": "2021-02-04",
"certification_date": "2021-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "44887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Vergne, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.