Active NPI
Mervin Jacob
- Pharmacist
- Marietta, GA
National Provider Identifier
1417743550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH033464
- Practice address
- 833 Campbell Hill St NW
Marietta, GA 30060-1134 - Phone
- (470) 560-0260
- NPI assigned
- Apr 16, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 | RPH033464 | GA | Primary |
Addresses
Primary practice location
833 Campbell Hill St NW
Marietta, GA 30060-1134
Mailing address
833 Campbell Hill St NW Ste 100
Marietta, GA 30060-1135
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 |
|---|---|---|---|
| RPH033464 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744761600000",
"number": "1417743550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 CAMPBELL HILL ST NW STE 100",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 CAMPBELL HILL ST NW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601134",
"telephone_number": "470-560-0260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "MERVIN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-04-16",
"last_updated": "2025-04-16",
"certification_date": "2025-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH033464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.