Individual provider Active NPI

Terry Roark, DPH

  • Pharmacist
  • Oneida, TN
National Provider Identifier
1992874382
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
7423 Issued in TN
Practice address
19118 Alberta St
Oneida, TN 37841-6003
Phone
(423) 569-9000
Fax
(423) 569-2402
NPI assigned
Nov 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7423 TN Primary

Addresses

Primary practice location

19118 Alberta St
Oneida, TN 37841-6003

Mailing address

19118 Alberta St
Oneida, TN 37841-6003
Phone (423) 569-9000

Other identifiers 1

IdentifierTypeStateIssuer
7423OtherTNPHARMACIST LICENSE NUMBER

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

LicenseStateTypeSpecialty
7423TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Homebiotics, Inc Current Accepting new patients

Locations

19118 Alberta St
Oneida, TN 37841
Phone (423) 569-2400

Organizations & group practices 3

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992874382",
    "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": "TERRY",
        "credential": "DPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "7423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "7423",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneida, TN

Sources for this page

  • 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.