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

KROGER PHARMACY
NPI 1316971054
Pharmacy - Community/Retail Pharmacy in Maryville, TN

Active since July 10, 2006CLIA 44D2081537 · Waiver
507 FOOTHILLS PLZ, MARYVILLE, TN 37801(865) 681-4924(865) 681-5180 Get Directions Write a Review

NPPES record last updated: April 6, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 6, 2023, May 16, 2016, Nov 13, 2015 (3 updates tracked since 2015).

About Kroger Pharmacy NPPES

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

KROGER PHARMACY (NPI 1316971054) is a healthcare organization registered as a community/retail pharmacy in Maryville, Tennessee and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through July 27, 2026 and lists Chelsie Craft, Pharmacy Licensing Asp, as its authorized official.

NPPES Registry Identity

NPI1316971054
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKROGER LIMITED PARTNERSHIP I
Location Address507 FOOTHILLS PLZMaryville, TN 37801-2312
Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092
Phone(865) 681-4924
Fax(865) 681-5180
Organization SubpartNo
Authorized OfficialChelsie CraftPharmacy Licensing Asp · (513) 762-1019
Enumeration DateJuly 10, 2006
Last NPPES UpdateApril 6, 20233 updates tracked since enumeration
NPPES CertifiedMarch 28, 2023
✔ NPI 1316971054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in TN · 3742
Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
507 FOOTHILLS PLZ, Maryville, TN 37801
Open in Google Maps ↗

Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 1

Other2093226Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 44D2081537

Kroger Limited Partnership Dba Kroger Pharmacy #683 · Maryville, TN
Active · expires Jul 27, 2026
CLIA Number44D2081537
Laboratory TypeRetail Pharmacy
Certificate Effective DateJuly 28, 2024
Certificate Expiration DateJuly 27, 2026
Laboratory DirectorBrenda Barnes
Laboratory Phone(865) 681-4924
Laboratory LocationKroger Limited Partnership Dba Kroger Pharmacy #683507 N Foothills Plaza, Maryville, TN 37801
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
252 services250 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
244 services242 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
33 services33 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
33 services33 patients
Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5ml dosage, for intramuscular use 91304
The COVID-19 vaccine you'll receive is designed to protect against the virus. It contains tiny, harmless pieces of the virus's spike protein. These trigger your immune system to build a defense. The vaccine also includes a saponin-based adjuvant to enhance this response. It's given as a 0.5ml injection into a muscle.
15 services15 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy #683 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy #683

DMEPOS supplier · Maryville, TNOperated by Kroger Limited Partnership I
✔

Accepts Medicare assignment

Kroger Pharmacy #683 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20597171
Medicare Participant SinceAugust 27, 2003
Supplier Location507 Foothills PlzMaryville, TN 37801
Phone(865) 681-4924
Supplier Specialties
Pharmacy Grocery Store

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 3

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

CARLA LARKIN
Nurse Practitioner (Family)
507 FOOTHILLS PLZ
MARYVILLE, TN 37801
Blount County (865) 681-4503
DR. NICHOLAS ANDREW PRINCE PHARM D.
Pharmacist
507 FOOTHILLS PLZ
MARYVILLE, TN 37801
Blount County (865) 238-7436
JANEA A THOMAS A.P.R.N.
Nurse Practitioner (Family)
507 FOOTHILLS PLZ
MARYVILLE, TN 37801
Blount County (865) 238-7450

Frequently Asked Questions

What is KROGER LIMITED PARTNERSHIP I's NPI number?

The NPI number assigned to this healthcare provider is 1316971054, enumerated as an "organization" on July 10, 2006.

Where is the provider located?

The provider is located at 507 FOOTHILLS PLZ MARYVILLE, TN 37801 and the phone number is (865) 681-4924.

What is the provider's specialty?

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

What insurance does KROGER LIMITED PARTNERSHIP I accept?

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.