KROGER
NPI 1043691009
Pharmacy in Knoxville, TN

NPI Status: Active since June 16, 2015

Contact Information

2217 N BROADWAY ST
KNOXVILLE, TN
ZIP 37917
Phone: (865) 525-4629

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  • Organization
  • Pharmacy
  • CLIA Number: 25D1021484
  • CLIA Cert. Type: Pharmacy
  • CLIA Exp. Date: 01-22-2026

About KROGER

This page provides the complete NPI Profile along with additional information for Kroger, a provider established in Knoxville, Tennessee operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1043691009 assigned on June 2015. The practitioner's primary taxonomy code is 333600000X with license number 39228 (TN). The provider is registered as an organization and their NPI record was last updated 11 years ago. The authorized official of this NPI record is Karla Langworthy (Manager Of Pharmacy Credentialing)

NPI
1043691009
Provider Name
KROGER
Entity Type
Organization
Location Address
2217 N BROADWAY ST KNOXVILLE, TN 37917
Location Phone
(865) 525-4629
Mailing Address
2217 N BROADWAY ST KNOXVILLE, TN 37917
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-16-2015
Last Update Date
06-16-2015
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy

Taxonomy Code
333600000X
Type
Suppliers
License No.
39228
License State
TN
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KARLA LANGWORTHY

Authorized Official Title
MANAGER OF PHARMACY CREDENTIALING
Authorized Official Phone
(513) 698-1878

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
25D1021484
Facility Type
Pharmacy
Certificate Effective Date
January 23, 2024
Certificate Expiration Date
January 22, 2026
Laboratory Director
CYNTHIA B. FISHER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Kroger to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1043691009, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
4
Doubled → 8
Pos 4
3
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
9
Unchanged
Pos 7
1
Doubled → 2
Pos 8
0
Unchanged
Pos 9
0
Doubled → 0
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 6 → 12 → 3 1 → 2 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 8 + 3 + 1 + 2 + 9 + 2 + 0 + 0 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1043691009.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Pharmacist
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Pharmacist
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Pharmacist
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Pharmacist
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Pharmacist
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Pharmacy (Community/Retail Pharmacy)
2217 N BROADWAY ST
KNOXVILLE, TN 37917
Pharmacist
2217 N BROADWAY ST
KNOXVILLE, TN 37917

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043691009, enumerated as an "organization" on June 16, 2015.

The provider is located at 2217 N BROADWAY ST KNOXVILLE, TN 37917 and the phone number is (865) 525-4629.

Pharmacy with taxonomy code 333600000X.