Individual provider Active NPI

Patria Lorraine Ybanez, PHARM D

  • Pharmacist
  • Peachtree City, GA
National Provider Identifier
1073117917
Registry record updated Nov 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH024333 Issued in GA
Practice address
101 Lexington Cir
Peachtree City, GA 30269-6845
Phone
(770) 486-1639
NPI assigned
Nov 22, 2020
Last updated
Nov 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH024333 GA Primary

Addresses

Primary practice location

101 Lexington Cir
Peachtree City, GA 30269-6845

Mailing address

190 Victoria Dr
Fayetteville, GA 30214-1163
Phone (404) 717-7221

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
RPH024333GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606003200000",
    "number": "1073117917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 VICTORIA DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141163",
            "telephone_number": "404-717-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LEXINGTON CIR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696845",
            "telephone_number": "770-486-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YBANEZ",
        "first_name": "PATRIA",
        "middle_name": "LORRAINE",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-22",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH024333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2020; 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.