Active NPI
Stephanie Theard I, PHARMD
- Pharmacist
- Commerce, GA
National Provider Identifier
1114370483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH029296
- Practice address
- 2100 N Broad St
Commerce, GA 30529-1700 - Phone
- (706) 336-5931
- NPI assigned
- Jul 21, 2016
- Last updated
- Jul 21, 2016
- Sex
- Female
- 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 | RPH029296 | GA | Primary |
Addresses
Primary practice location
2100 N Broad St
Commerce, GA 30529-1700
Mailing address
1235 Chase Common Dr
Norcross, GA 30071-3555
Phone (786) 473-7222
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH029296 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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, 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": "1469059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469059200000",
"number": "1114370483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1235 CHASE COMMON DR",
"city": "NORCROSS",
"state": "GA",
"postal_code": "300713555",
"telephone_number": "786-473-7222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 N BROAD ST",
"city": "COMMERCE",
"state": "GA",
"postal_code": "305291700",
"telephone_number": "706-336-5931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEARD",
"first_name": "STEPHANIE",
"name_suffix": "I",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-21",
"last_updated": "2016-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH029296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commerce, GA
- Surgeoncare Physicians of Georgia, LLC
- Sylvanus Memorial Treatment Centers Inc. (William W. Read Memorial Treatment Center)
- Symphony Respriratory Services (Golden Care of Commerce)
- T Hannah Host Home
- Kari Tatum
- Samuel Keith Thomason, DMD
- Tiger Town Compounding Inc (Tiger Town Compounding)
- Trademark Medical Transport of Commerce, Inc
- Laurie Truitt, OTR
- Joshua W. Upton, PHARMD.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.