Active NPI
Jaci Michelle Dillard
- Pharmacist
- Dallas, GA
National Provider Identifier
1316547557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH02422
- Practice address
- 3615 Charles Hardy Pkwy
Dallas, GA 30157-9472 - Phone
- (770) 445-9096
- NPI assigned
- Oct 27, 2020
- Sex
- Female
- 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 | RPH02422 | GA | Primary |
Addresses
Primary practice location
3615 Charles Hardy Pkwy
Dallas, GA 30157-9472
Mailing address
1269 Mackintosh Park NW
Atlanta, GA 30318-4177
Phone (770) 851-7880
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 |
|---|---|---|---|
| RPH02422 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603756800000",
"number": "1316547557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1269 MACKINTOSH PARK NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303184177",
"telephone_number": "770-851-7880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3615 CHARLES HARDY PKWY",
"city": "DALLAS",
"state": "GA",
"postal_code": "301579472",
"telephone_number": "770-445-9096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLARD",
"first_name": "JACI",
"middle_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-27",
"last_updated": "2020-10-27",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH02422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.