Individual provider Active NPI

Tina Rezakhani

  • Pharmacist
  • Roswell, GA
National Provider Identifier
1154661817
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH026431 Issued in GA
Practice address
1135 Woodstock Rd
Roswell, GA 30075-2231
Phone
(770) 998-7122
NPI assigned
Feb 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH026431 GA Primary

Addresses

Primary practice location

1135 Woodstock Rd
Roswell, GA 30075-2231

Mailing address

1135 Woodstock Rd
Roswell, GA 30075-2231

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

LicenseStateTypeSpecialty
RPH026431GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1154661817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 WOODSTOCK RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 WOODSTOCK RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752231",
            "telephone_number": "770-998-7122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZAKHANI",
        "first_name": "TINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-18",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH026431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; 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.