Individual provider Active NPI

Jerrica Lanise Dodd, PHARMD, MS

  • Pharmacist
  • Marietta, GA
National Provider Identifier
1003320326
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH22274 Issued in GA
Practice address
2499 Red Barn Rd SW
Marietta, GA 30064-4905
Phone
(770) 316-5497
NPI assigned
Nov 22, 2017
Last updated
Nov 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS34036 FL
Pharmacist 183500000X 03223091 OH
Pharmacist 183500000X RPH22274 GA Primary

Addresses

Primary practice location

2499 Red Barn Rd SW
Marietta, GA 30064-4905

Mailing address

1750 Powder Springs Rd SW
Suite 190, PMB 295
Marietta, GA 30064-4861
Phone (770) 316-5497

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
Credentials
Master of Science, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS34036FLMDPharmacist
RPH22274GAMDPharmacist
03223091OHMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1003320326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 POWDER SPRINGS RD SW",
            "address_2": "SUITE 190, PMB 295",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644861",
            "telephone_number": "770-316-5497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2499 RED BARN RD SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644905",
            "telephone_number": "770-316-5497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODD",
        "first_name": "JERRICA",
        "middle_name": "LANISE",
        "name_prefix": "Dr.",
        "credential": "PHARMD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-22",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS34036",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03223091",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH22274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; 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.