Active NPI
Kathryn E Peth, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Gainesville, GA
National Provider Identifier
1295363034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- RPH023240
- Practice address
- 3630 Thompson Bridge Rd
Gainesville, GA 30506-1519 - Phone
- (770) 532-5141
- Fax
- (770) 532-3395
- NPI assigned
- Mar 28, 2020
- Sex
- Female
- Sole proprietor
- No
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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH023240 | GA | Primary |
Addresses
Primary practice location
3630 Thompson Bridge Rd
Gainesville, GA 30506-1519
Mailing address
3630 Thompson Bridge Rd
Gainesville, GA 30506-1519
Phone (770) 532-5141
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH023240 | GA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Kroger Co | Past | Accepting new patients | |
| Kroger Co | Past | 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, 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": "1585353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585353600000",
"number": "1295363034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3630 THOMPSON BRIDGE RD",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305061519",
"telephone_number": "770-532-5141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3630 THOMPSON BRIDGE RD",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305061519",
"telephone_number": "770-532-5141",
"fax_number": "770-532-3395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETH",
"first_name": "KATHRYN",
"middle_name": "E",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-28",
"last_updated": "2020-03-28",
"certification_date": "2020-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "GA",
"license": "RPH023240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.