Active NPI
Allegra Vanessa McDonald Fadeyi, PHARMD, CGP
- Geriatric Pharmacist
- Cordova, TN
National Provider Identifier
1457748782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Pharmacist
- License
- 36005
- Practice address
- 643 Rocky Field Dr
Cordova, TN 38018-6550 - Phone
- (804) 651-6429
- NPI assigned
- Apr 24, 2015
- Last updated
- Apr 24, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 36005 | TN | Primary |
| Geriatric Pharmacist | 1835G0303X | P-11728 | MS | |
| Geriatric Pharmacist | 1835G0303X | 0202205262 | VA |
Addresses
Primary practice location
643 Rocky Field Dr
Cordova, TN 38018-6550
Mailing address
643 Rocky Field Drive
Cordova, TN 38018-6550
Phone (804) 651-6429
Other names 1
- Allegra McDonald Fadeyi
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 |
|---|---|---|---|
| P-11728 | MS | MD | Geriatric Pharmacist |
| 0202205262 | VA | MD | Geriatric Pharmacist |
| 36005 | TN | MD | Interventional Cardiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429833600000",
"number": "1457748782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "643 ROCKY FIELD DRIVE",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380186550",
"telephone_number": "804-651-6429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "643 ROCKY FIELD DR",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380186550",
"telephone_number": "804-651-6429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADEYI",
"first_name": "ALLEGRA",
"middle_name": "VANESSA MCDONALD",
"credential": "PHARMD, CGP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-24",
"last_updated": "2015-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "TN",
"license": "36005",
"primary": true
},
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "MS",
"license": "P-11728",
"primary": false
},
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "VA",
"license": "0202205262",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALLEGRA",
"last_name": "MCDONALD FADEYI",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Cordova, TN
- Exploratory Centers of America, LLC
- Exploratory Centers of America, LLC
- Extended Quality of Life, LLC
- Eye Care Associates of Co, LLC
- Eyemart Express LTD (EyeMart Express)
- Oluwatosin A Fadeyi, PHARMD/MBA
- Lisa Diane Fair, PMHNP-BC
- Fairhaven Holdings, LLC (Fairhaven Treatment Center)
- Fairhaven Treatment Center
- Faith and Hope Healthcare Transportation, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.