Active NPI
Andy Tran
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Stone Mountain, GA
National Provider Identifier
1336779313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- RPH028007
- Practice address
- 1232 S Hairston Rd
Stone Mountain, GA 30088-2715 - Phone
- (404) 292-5542
- NPI assigned
- Jan 18, 2020
- 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH028007 | GA | Primary |
Addresses
Primary practice location
1232 S Hairston Rd
Stone Mountain, GA 30088-2715
Mailing address
1232 S Hairston Rd
Stone Mountain, GA 30088-2715
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 |
|---|---|---|---|
| RPH028007 | GA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579305600000",
"number": "1336779313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1232 S HAIRSTON RD",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300882715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1232 S HAIRSTON RD",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300882715",
"telephone_number": "404-292-5542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN",
"first_name": "ANDY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-18",
"last_updated": "2020-01-18",
"certification_date": "2020-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "GA",
"license": "RPH028007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stone Mountain, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.