Kim David Ragan, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH016377 Issued in GA

Practice address

150 Stonehaven Dr
Fayetteville, GA 30215-2967

Phone

(678) 378-3300

Fax

(901) 284-0113

NPI assigned

May 14, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1396181657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 STONEHAVEN DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152967",
            "telephone_number": "678-378-3300",
            "fax_number": "901-284-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 STONEHAVEN DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152967",
            "telephone_number": "678-378-3300",
            "fax_number": "901-284-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGAN",
        "first_name": "KIM",
        "middle_name": "DAVID",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH016377",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "040314",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.