Active NPI
Kerry B Wynn, PHARMD
- Pharmacist
- Atlanta, GA
National Provider Identifier
1417097478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH021387
- Practice address
- 116 Richardson St SE
Atlanta, GA 30312-2918 - Phone
- (404) 589-0554
- NPI assigned
- Feb 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH021387 | GA | Primary |
| Pharmacotherapy Pharmacist | 1835P1200X | RPH021387 | GA |
Addresses
Primary practice location
116 Richardson St SE
Atlanta, GA 30312-2918
Mailing address
116 Richardson St SE
Atlanta, GA 30312-2918
Phone (404) 589-0554
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH021387 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1417097478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 RICHARDSON ST SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303122918",
"telephone_number": "404-589-0554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 RICHARDSON ST SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303122918",
"telephone_number": "404-589-0554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYNN",
"first_name": "KERRY",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH021387",
"primary": true
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "GA",
"license": "RPH021387",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.