Cody Michael Childers, PHARM. D.

Primary specialty

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

License

E-14467 Issued in MS

Practice address

6745 S Siwell Rd
Byram, MS 39272-8747

Phone

(601) 863-2004

NPI assigned

Jul 11, 2016

Last updated

Jan 13, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Kroger Limited Partnership I

  dba Kroger Pharmacy #490

  • Community/Retail Pharmacy
  • Byram, MS
  • NPI 1467486241
  NPD (past)
• Kroger Limited Partnership I

  dba Kroger Pharmacy #473

  • Community/Retail Pharmacy
  • Newport, KY
  • NPI 1104791078
  NPD (past)

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1306298633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 MULLHERRIN DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391104534",
            "telephone_number": "901-482-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6745 S SIWELL RD",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392728747",
            "telephone_number": "601-863-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "CODY",
        "middle_name": "MICHAEL",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-14467",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MS",
            "license": "E-14467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Mississippi Civic Improvement Association, Inc (Gary Road Elementary School)
• Central Mississippi Civic Improvement Association, Inc. (Gary Road Elementary School)
• Shukundala Clark Champion, DSW, LCSW
• Change Happens Counseling Center, LLC
• Chase Personal Care Home Services
• Dora L Chism
• Billy Clay Clanton Jr., R.PH.
• Clinton Medical Center
• Kimberly C Collins, OT
• Joe Christopher Cook I, MD, M.P.H., A.T.C

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Byram, MS
• Providers in Byram, MS by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.