Individual provider Active NPI

Jon Macfadden, RPH

  • Pharmacist
  • East Ellijay, GA
National Provider Identifier
1326412545
Registry record updated Nov 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH019421 Issued in GA
Practice address
192 1St Ave
East Ellijay, GA 30540-8101
Phone
(770) 635-2241
NPI assigned
Nov 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH019421 GA Primary

Addresses

Primary practice location

192 1St Ave
East Ellijay, GA 30540-8101

Mailing address

192 1St Ave
East Ellijay, GA 30540-8101
Phone (770) 635-2241

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH019421GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1448496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448496000000",
    "number": "1326412545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 1ST AVE",
            "city": "EAST ELLIJAY",
            "state": "GA",
            "postal_code": "305408101",
            "telephone_number": "770-635-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 1ST AVE",
            "city": "EAST ELLIJAY",
            "state": "GA",
            "postal_code": "305408101",
            "telephone_number": "770-635-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACFADDEN",
        "first_name": "JON",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-26",
        "last_updated": "2015-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH019421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Ellijay, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2015; 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.