Individual provider Active NPI

Andraya Johnson Hibbert, PHARMD

  • Pharmacist
  • Atlanta, GA
National Provider Identifier
1013266642
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
52148 Issued in TX
Practice address
1874 Piedmont Ave NE Ste 100a
Atlanta, GA 30324-4816
Phone
(404) 733-6800
NPI assigned
Aug 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 52148 TX Primary

Addresses

Primary practice location

1874 Piedmont Ave NE Ste 100a
Atlanta, GA 30324-4816

Mailing address

1874 Piedmont Ave NE Ste 100a
Atlanta, GA 30324-4816
Phone (770) 401-0222

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
52148TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Oct 13, 2024 Accepting new patients
Walgreen Co PastSince Oct 13, 2024 Accepting new patients

Locations

1874 Piedmont Ave NE
Ste 100A
Atlanta, GA 30324
Phone (404) 733-6800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1013266642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1874 PIEDMONT AVE NE STE 100A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303244816",
            "telephone_number": "770-401-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1874 PIEDMONT AVE NE STE 100A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303244816",
            "telephone_number": "404-733-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBERT",
        "first_name": "ANDRAYA",
        "middle_name": "JOHNSON",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "52148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.