Individual provider Active NPI

Alyxandria Fiveash

  • Pharmacist
  • Cairo, GA
National Provider Identifier
1245842376
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH030928 Issued in GA
Practice address
501 US Highway 84 E
Cairo, GA 39828-1852
Phone
(229) 359-0832
NPI assigned
Aug 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH030928 GA Primary

Addresses

Primary practice location

501 US Highway 84 E
Cairo, GA 39828-1852

Mailing address

501 US Highway 84 E
Cairo, GA 39828-1852

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
RPH030928GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Mar 20, 2022 Accepting new patients
Walgreen Co PastSince Aug 23, 2020 Accepting new patients

Locations

501 US Highway 84 E
Cairo, GA 39828
Phone (229) 359-0832

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": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1245842376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 US HIGHWAY 84 E",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398281852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 US HIGHWAY 84 E",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398281852",
            "telephone_number": "229-359-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIVEASH",
        "first_name": "ALYXANDRIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH030928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cairo, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.