Active NPI
Chris Ezeanii
- Pharmacist
- Marietta, GA
National Provider Identifier
1104974211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 020235
- Practice address
- 525 Franklin Gtwy SE
Marietta, GA 30067-7707 - Phone
- (678) 581-1223
- Fax
- (678) 581-2356
- NPI assigned
- Jan 8, 2007
- Last updated
- Jan 9, 2021
- Sex
- Male
- 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 | 020235 | GA | Primary |
Addresses
Primary practice location
525 Franklin Gtwy SE
Marietta, GA 30067-7707
Mailing address
525 Franklin Gtwy SE
Marietta, GA 30067-7707
Phone (678) 581-1223
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yetola Inc | Pharmacist | Current | Accepting new patients |
Locations
525 Franklin Gtwy SE
Marietta, GA 30067
Phone (678) 581-1223
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610150400000",
"number": "1104974211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 FRANKLIN GTWY SE",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300677707",
"telephone_number": "678-581-1223",
"fax_number": "678-581-2356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 FRANKLIN GTWY SE",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300677707",
"telephone_number": "678-581-1223",
"fax_number": "678-581-2356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZEANII",
"first_name": "CHRIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2021-01-09",
"certification_date": "2021-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "020235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.