Active NPI
Ian Douglas Dyson, RPH
- Pharmacist
- Covington, GA
National Provider Identifier
1417672262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH033974
- Practice address
- 5384 Highway 20 S
Covington, GA 30016-4403 - Phone
- (770) 788-6566
- NPI assigned
- Oct 4, 2022
- Last updated
- Nov 10, 2022
- 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 | RPH033974 | GA | Primary |
Addresses
Primary practice location
5384 Highway 20 S
Covington, GA 30016-4403
Mailing address
5384 Highway 20 S
Covington, GA 30016-4403
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH033974 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia CVS Pharmacy L.L.C | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668038400000",
"number": "1417672262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5384 HIGHWAY 20 S",
"city": "COVINGTON",
"state": "GA",
"postal_code": "300164403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5384 HIGHWAY 20 S",
"city": "COVINGTON",
"state": "GA",
"postal_code": "300164403",
"telephone_number": "770-788-6566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYSON",
"first_name": "IAN",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-04",
"last_updated": "2022-11-10",
"certification_date": "2022-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH033974",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, GA
- Dsi Renal Inc (NRI Covington)
- Audrey C Dudzik, MD
- Sheila B Dukes, RPH
- Evadnie Durant, FNP
- DWF Wellness, LLC
- E & C Nonmedical Home Care Services LLC
- Eagle Eye and Medical Clinic Inc (covington vision center)
- Christine Earle, M.A., PH.D.
- East Atlanta Dental Associates LLC
- East Atlanta Endoscopy Centers, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.