Active NPI
Krista Jeriann Parks, PHARMD
- Pharmacist
- Dacula, GA
National Provider Identifier
1437757804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH18799
- Practice address
- 2700 Braselton Hwy
Dacula, GA 30019-3262 - Phone
- (770) 614-1022
- Fax
- (770) 614-4413
- NPI assigned
- Oct 16, 2020
- Sex
- Female
- 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 | RPH18799 | GA | Primary |
Addresses
Primary practice location
2700 Braselton Hwy
Dacula, GA 30019-3262
Mailing address
2700 Braselton Hwy
Dacula, GA 30019-3262
Phone (770) 614-1022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KP4841 | Medicaid | GA |
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 |
|---|---|---|---|
| RPH18799 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602806400000",
"number": "1437757804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 BRASELTON HWY",
"city": "DACULA",
"state": "GA",
"postal_code": "300193262",
"telephone_number": "770-614-1022",
"fax_number": "770-614-4413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 BRASELTON HWY",
"city": "DACULA",
"state": "GA",
"postal_code": "300193262",
"telephone_number": "770-614-1022",
"fax_number": "770-614-4413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKS",
"first_name": "KRISTA",
"middle_name": "JERIANN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-16",
"last_updated": "2020-10-16",
"certification_date": "2020-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH18799",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "KP4841",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dacula, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.