Individual provider Active NPI

Thao Tran

  • Pharmacist
  • Evans, GA
National Provider Identifier
1194558155
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
026763 Issued in GA
Practice address
1044 Furys Ferry Rd
Evans, GA 30809-4208
Phone
(706) 860-3945
NPI assigned
Aug 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 026763 GA Primary

Addresses

Primary practice location

1044 Furys Ferry Rd
Evans, GA 30809-4208

Mailing address

120 Greenwood Dr
Augusta, GA 30907-1406

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
026763GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia CVS Pharmacy L.L.C. PastSince Aug 25, 2024 Accepting new patients
Georgia CVS Pharmacy L.L.C PastSince Aug 25, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1194558155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 GREENWOOD DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309071406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 FURYS FERRY RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094208",
            "telephone_number": "706-860-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "THAO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "026763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.