Active NPI
James Thomas Fanning IV, PHARM. D.
- Pharmacist
- Marietta, GA
National Provider Identifier
1437525458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 028545
- Practice address
- 3930 Shallowford Rd
Marietta, GA 30062-5014 - Phone
- (770) 640-5643
- Fax
- (678) 352-1807
- NPI assigned
- Aug 13, 2015
- 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 | 028545 | GA | Primary |
Addresses
Primary practice location
3930 Shallowford Rd
Marietta, GA 30062-5014
Mailing address
3930 Shallowford Rd
Marietta, GA 30062-5014
Phone (770) 640-5643
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 |
|---|---|---|---|
| 028545 | 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": "1439424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439424000000",
"number": "1437525458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3930 SHALLOWFORD RD",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300625014",
"telephone_number": "770-640-5643",
"fax_number": "678-352-1807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3930 SHALLOWFORD RD",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300625014",
"telephone_number": "770-640-5643",
"fax_number": "678-352-1807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANNING",
"first_name": "JAMES",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "PHARM. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-13",
"last_updated": "2015-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "028545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
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- Chuan Frances Fan, MD
- Lincoln Robert Fantaski, DMD
- Benyamin Farahvash, M.D.
- Marisa Fargnoli
- David Farino, PHARM.D.
- Azim Farishta
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.