1. Home
  2. Directory
  3. Tennessee
  4. Knoxville
  5. Pharmacy
  6. NPI Profile

KROGER
NPI 1043691009
Pharmacy in Knoxville, TN

Active since June 16, 2015CLIA Certified · 2 labs
2217 N BROADWAY ST, KNOXVILLE, TN 37917(865) 525-4629 Get Directions Write a Review

NPPES record last updated: June 16, 2015. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kroger NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KROGER (NPI 1043691009) is a healthcare organization registered as a pharmacy in Knoxville, Tennessee and active in the NPI registry since June 2015. The organization holds 2 active CLIA laboratory certificates and lists Karla Langworthy, Manager Of Pharmacy Credentialing, as its authorized official.

NPPES Registry Identity

NPI1043691009
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameKROGER
Location Address2217 N BROADWAY STKnoxville, TN 37917-4719
Mailing Address2217 N Broadway StKnoxville, TN 37917-4719
Phone(865) 525-4629
Organization SubpartNo
Authorized OfficialKarla LangworthyManager Of Pharmacy Credentialing · (513) 698-1878
Enumeration DateJune 16, 2015
✔ NPI 1043691009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in TN · 39228
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
2217 N BROADWAY ST, Knoxville, TN 37917
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D1021484

Kroger Pharmacy #492 · Madison, MS
Active · expires Jan 22, 2028
CLIA Number25D1021484
Laboratory TypePharmacy
Certificate Effective DateJanuary 23, 2026
Certificate Expiration DateJanuary 22, 2028
Laboratory DirectorCynthia B. Fisher
Laboratory Phone(513) 698-1878
Laboratory LocationKroger Pharmacy #4921070 Hwy 51, Madison, MS 39110
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 44D2081516

Kroger Pharmacy #506 · Knoxville, TN
Active · expires Jul 27, 2028
CLIA Number44D2081516
Laboratory TypeRetail Pharmacy
Certificate Effective DateJuly 28, 2026
Certificate Expiration DateJuly 27, 2028
Laboratory DirectorBrenda Barnes
Laboratory Phone(865) 524-4629
Laboratory LocationKroger Pharmacy #5062217 Broadway, Knoxville, TN 37917
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KROGER LIMITED PARTNERSHIP I
Pharmacy (Community/Retail Pharmacy)
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Knox County (865) 525-4629
DR. SHERRON E KNOWLES
Pharmacist
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Knox County (865) 525-4633
DR. JAMES PERDIE RAINES JR. D.PH.
Pharmacist
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Knox County (865) 525-4629
RYAN CHRISTOPHER PRATT PHARM D
Pharmacist
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Knox County (865) 525-4629
DARREN CROWDER
Pharmacist
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Knox County (865) 525-4629
DR. BRANDON THOMAS LOCK PHARM.D.
Pharmacist
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Knox County (865) 525-4629
GREGORY SCOTT HOLLEY PHARMD
Pharmacist
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Knox County (865) 525-4629

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kroger's NPI number?

The NPI number for Kroger is 1043691009. It was assigned to this organization in the NPPES registry on June 16, 2015.

Where is Kroger located?

Kroger is located at 2217 N Broadway St, Knoxville, TN 37917. The listed phone number is (865) 525-4629.

What is Kroger's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Kroger hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Kroger was last updated on June 16, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.