Active NPI
Ben Braddy
- Pharmacist
- Milledgeville, GA
National Provider Identifier
1285787408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15300
- Practice address
- 200 W Andrews St
Milledgeville, GA 31061-3839 - Phone
- (478) 454-1026
- NPI assigned
- Jan 19, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 15300 | GA | Primary |
Addresses
Primary practice location
200 W Andrews St
Milledgeville, GA 31061-3839
Mailing address
200 W Andrews St
Milledgeville, GA 31061
Phone (478) 454-1026
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15300 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southside Drugs Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Southside Discount Drugs
- Community/Retail Pharmacy
- Milledgeville, GA
- NPI 1184795577
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285787408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W ANDREWS ST",
"city": "MILLEDGEVILLE",
"state": "GA",
"postal_code": "31061",
"telephone_number": "478-454-1026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W ANDREWS ST",
"city": "MILLEDGEVILLE",
"state": "GA",
"postal_code": "310613839",
"telephone_number": "478-454-1026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADDY",
"first_name": "BEN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "15300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milledgeville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.