Active NPI
Aida Attia Faltas
- Pharmacist
- Antioch, TN
National Provider Identifier
1023516580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 019546
- Practice address
- 608 Copper Rideg Trail
Antioch, TN 37013 - Phone
- (615) 710-0464
- NPI assigned
- Jan 30, 2018
- Last updated
- Jan 30, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 019546 | KY | Primary |
Addresses
Primary practice location
608 Copper Rideg Trail
Antioch, TN 37013
Mailing address
608 Copper Ridge TRL
Antioch, TN 37013-4233
Phone (615) 710-0464
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019546 | Other | KY | PHARMACIST |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019546 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517270400000",
"number": "1023516580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "608 COPPER RIDGE TRL",
"city": "ANTIOCH",
"state": "TN",
"postal_code": "370134233",
"telephone_number": "615-710-0464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "608 COPPER RIDEG TRAIL",
"city": "ANTIOCH",
"state": "TN",
"postal_code": "37013",
"telephone_number": "615-710-0464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALTAS",
"first_name": "AIDA",
"middle_name": "ATTIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-30",
"last_updated": "2018-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "019546",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "019546",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Antioch, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.