Active NPI
Dustin Brant Cooper
- Pharmacist
- Griffin, GA
National Provider Identifier
1346848074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH027824
- Practice address
- 1524 Highway 16 W
Griffin, GA 30223-2046 - Phone
- (770) 229-7430
- NPI assigned
- Oct 14, 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 | 183500000X | RPH027824 | GA | Primary |
Addresses
Primary practice location
1524 Highway 16 W
Griffin, GA 30223-2046
Mailing address
500 Twelve Oaks Dr
Senoia, GA 30276-2366
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 |
|---|---|---|---|
| RPH027824 | GA | MD | Pharmacist |
Practice roles
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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Bethlehem, GA
- NPI 1154294205
-
- Community/Retail Pharmacy
- Griffin, GA
- NPI 1629321823
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1346848074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 TWELVE OAKS DR",
"city": "SENOIA",
"state": "GA",
"postal_code": "302762366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1524 HIGHWAY 16 W",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302232046",
"telephone_number": "770-229-7430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "DUSTIN",
"middle_name": "BRANT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-14",
"last_updated": "2020-10-14",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH027824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Griffin, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.