Publix Tennessee, LLC
NPI 1629768957 · Community/Retail Pharmacy · Ooltewah, TN
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Publix Tennessee, LLC is a Community/Retail Pharmacy organization in Ooltewah, TN (NPI 1629768957).
Provider details
- NPI number
- 1629768957
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Dain Rusk, Vice President of Pharmacy(863) 688-1188
Specialties & taxonomies
Suppliers
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
3 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
158 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Administration of Influenza Virus VaccineG0008 | 110 | $20 |
| Admn Sarscov2 Vacc 1 Dose90480 | 48 | $40 |
Typical Medicare-allowed amounts for these services range $20–$40 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Publix Pharmacy #1863
- Doing business as
- Publix Pharmacy #1863
Registry dates
- Enumerated
- 2023-05-10
- Last updated
- 2023-09-29
- Certified
- 2023-09-29
Frequently asked questions
- What is Publix Tennessee, LLC's NPI number?
- Publix Tennessee, LLC's National Provider Identifier (NPI) is 1629768957, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Publix Tennessee, LLC?
- Publix Tennessee, LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Publix Tennessee, LLC located?
- Publix Tennessee, LLC's practice location on file with NPPES is 1688 Ooltewah Ringgold Rd, Suite 100, Ooltewah, TN 37363.
- What is Publix Tennessee, LLC's phone number?
- The practice phone number listed in the NPPES registry for Publix Tennessee, LLC is (423) 508-6835.
- Does Publix Tennessee, LLC accept Medicare?
- Publix Tennessee, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Publix Tennessee, LLC?
- The authorized official listed on Publix Tennessee, LLC's NPPES record is Dain Rusk, Vice President of Pharmacy. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Publix Tennessee, LLC's NPI active?
- Yes — Publix Tennessee, LLC's NPI (1629768957) is active in the NPPES registry as of the last update on 2023-09-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.