Individual provider Active NPI

Julie Bohannon, PHARMD

  • Pharmacist
  • Ooltewah, TN
National Provider Identifier
1992191357
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9631 Issued in TN
Practice address
5032 Ooltewah Ringgold Rd
Suite 100
Ooltewah, TN 37363-7091
Phone
(423) 396-6963
Fax
(423) 396-6947
NPI assigned
Apr 13, 2015
Last updated
Apr 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 9631 TN Primary

Addresses

Primary practice location

5032 Ooltewah Ringgold Rd
Suite 100
Ooltewah, TN 37363-7091

Mailing address

5032 Ooltewah Ringgold Rd
Suite 100
Ooltewah, TN 37363-7091
Phone (423) 396-6963

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

LicenseStateTypeSpecialty
9631TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1992191357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5032 OOLTEWAH RINGGOLD RD",
            "address_2": "SUITE 100",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637091",
            "telephone_number": "423-396-6963",
            "fax_number": "423-396-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5032 OOLTEWAH RINGGOLD RD",
            "address_2": "SUITE 100",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637091",
            "telephone_number": "423-396-6963",
            "fax_number": "423-396-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANNON",
        "first_name": "JULIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "9631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ooltewah, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.