Individual provider Active NPI

Jonathan Amha Aklilu, PHARMD

  • Pharmacist
  • Mount Juliet, TN
National Provider Identifier
1366033623
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH032365 Issued in GA
Practice address
2154 Ponty Pool Dr
Mount Juliet, TN 37122-7455
Phone
(615) 734-9839
NPI assigned
Jan 29, 2021
Last updated
Jan 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH032365 GA Primary

Addresses

Primary practice location

2154 Ponty Pool Dr
Mount Juliet, TN 37122-7455

Mailing address

2154 Ponty Pool Dr
Mount Juliet, TN 37122-7455

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH032365GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1366033623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2154 PONTY POOL DR",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371227455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 PONTY POOL DR",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371227455",
            "telephone_number": "615-734-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKLILU",
        "first_name": "JONATHAN",
        "middle_name": "AMHA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH032365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.