Individual provider Active NPI

Edward Griffin Reynolds, PHARMD

  • Pharmacist
  • Madison, GA
National Provider Identifier
1053934018
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH030971 Issued in GA
Practice address
218 S Main St
Madison, GA 30650-1303
Phone
(063) 424-1417
Fax
(706) 342-3297
NPI assigned
May 26, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH030971 GA Primary
Pharmacist 183500000X 42538 TN

Addresses

Primary practice location

218 S Main St
Madison, GA 30650-1303

Mailing address

218 S Main St
Madison, GA 30650-1303
Phone (063) 424-1417

Other practice location 1

1420 E Evans St
Bainbridge, GA 39819-4336
Phone (229) 246-7200

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
RPH030971GAMDPharmacist
42538TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Mac Discount Drugs, Inc CurrentSince Aug 13, 2023 Accepting new patients
Thrifty Mac Discount Drugs, Inc CurrentSince Aug 13, 2023 Accepting new patients

Locations

218 S Main St
Madison, GA 30650
Phone (706) 342-4141

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1053934018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 S MAIN ST",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306501303",
            "telephone_number": "063-424-1417",
            "fax_number": "706-342-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 S MAIN ST",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306501303",
            "telephone_number": "063-424-1417",
            "fax_number": "706-342-3297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1420 E Evans St",
            "address_purpose": "LOCATION",
            "city": "Bainbridge",
            "state": "GA",
            "postal_code": "398194336",
            "country_code": "US",
            "telephone_number": "229-246-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "EDWARD",
        "middle_name": "GRIFFIN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-26",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH030971",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "42538",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.