Jeffrey Rakestraw

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

016922 Issued in GA

Practice address

457 Nathan Dean Blvd
Dallas, GA 30132-4911

Phone

(770) 443-8776

NPI assigned

Jan 28, 2020

Last updated

Jan 28, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• The Kroger Co

  dba Kroger Pharmacy

  • Community/Retail Pharmacy
  • Dallas, GA
  • NPI 1093730871
  NPD
• Kroger Co

  dba Kroger Drugstore #622

  • Community/Retail Pharmacy
  • Bethlehem, GA
  • NPI 1154294205
  NPD (past)

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1235760430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 NATHAN DEAN BLVD",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301324911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 NATHAN DEAN BLVD",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301324911",
            "telephone_number": "770-443-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKESTRAW",
        "first_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "GA",
            "license": "016922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Publix Super Markets Inc (Publix Pharmacy #1217)
• Garrett Purnell
• Pyfa Prestige Services LLC
• Quality Care Senior Sitting Services, LLC
• Ismail Raheem
• Brittney K. Rampley, M.ED., CCC-SLP
• Jessica Ramskogler
• Angela Foreman Raney, FNP
• Mary K Rau, PA-C
• Yolonda Michelle Rawls

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Dallas, GA
• Providers in Dallas, GA by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.