Active NPI
Jason Eapen
- Pharmacist
- McDonough, GA
National Provider Identifier
1063780849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH025286
- Practice address
- 204 Jonesboro Rd
McDonough, GA 30253-3720 - Phone
- (678) 583-5381
- Fax
- (678) 583-1271
- NPI assigned
- Dec 7, 2011
- Sex
- Male
- Sole proprietor
- No
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 | RPH025286 | GA | Primary |
Addresses
Primary practice location
204 Jonesboro Rd
McDonough, GA 30253-3720
Mailing address
204 Jonesboro Rd
McDonough, GA 30253-3720
Phone (678) 583-5381
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 |
|---|---|---|---|
| RPH025286 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
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": "1323216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323216000000",
"number": "1063780849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 JONESBORO RD",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302533720",
"telephone_number": "678-583-5381",
"fax_number": "678-583-1271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 JONESBORO RD",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302533720",
"telephone_number": "678-583-5381",
"fax_number": "678-583-1271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAPEN",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-07",
"last_updated": "2011-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH025286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in McDonough, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.