Active NPI
Paul Livernois, RPH
- Pharmacist
- Millington, TN
National Provider Identifier
1992243000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29470
- Practice address
- S-752 Tarawa Ave
Millington, TN 38054 - Phone
- (901) 874-6121
- NPI assigned
- Feb 9, 2017
- 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 | 29470 | FL | Primary |
Addresses
Primary practice location
S-752 Tarawa Ave
Millington, TN 38054
Mailing address
819 Susan Cir
Drummonds, TN 38023-6843
Phone (901) 874-6121
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992243000 | Other | TN | TRI-CARE |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29470 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492041600000",
"number": "1992243000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "819 SUSAN CIR",
"city": "DRUMMONDS",
"state": "TN",
"postal_code": "380236843",
"telephone_number": "901-874-6121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "S-752 TARAWA AVE",
"city": "MILLINGTON",
"state": "TN",
"postal_code": "38054",
"telephone_number": "901-874-6121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIVERNOIS",
"first_name": "PAUL",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-09",
"last_updated": "2017-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "29470",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRI-CARE",
"identifier": "1992243000",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Millington, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.