Active NPI
Alex Gattis
- Pharmacist
- Tupelo, MS
National Provider Identifier
1326690876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- IE-16139
- Practice address
- 834 Barnes Crossing Rd
Tupelo, MS 38804-0909 - Phone
- (662) 840-8462
- NPI assigned
- Jul 15, 2019
- Last updated
- Jul 15, 2019
- Sex
- Male
- 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 | 183500000X | IE-16139 | MS | Primary |
Addresses
Primary practice location
834 Barnes Crossing Rd
Tupelo, MS 38804-0909
Mailing address
3901 Nita Lake Rd
Fulton, MS 38843-7124
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | icp |
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 |
|---|---|---|---|
| IE-16139 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
834 Barnes Crossing Rd
Tupelo, MS 38804
Phone (662) 840-8461
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": "1563148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563148800000",
"number": "1326690876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 NITA LAKE RD",
"city": "FULTON",
"state": "MS",
"postal_code": "388437124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "834 BARNES CROSSING RD",
"city": "TUPELO",
"state": "MS",
"postal_code": "388040909",
"telephone_number": "662-840-8462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATTIS",
"first_name": "ALEX",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-15",
"last_updated": "2019-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "IE-16139",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "icp",
"affiliation": "N",
"address_1": "834 Barnes Crossing Rd",
"city": "Tupelo",
"state": "MS",
"country_code": "US",
"postal_code": "388040909",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.