Individual provider Active NPI

Tanviben Wadiwala

  • Pharmacist
  • Warner Robins, GA
National Provider Identifier
1467223834
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH028348 Issued in GA
Practice address
1081 Ga Highway 96
Warner Robins, GA 31088-2507
Phone
(478) 987-7494
NPI assigned
Jan 12, 2024
Last updated
Jan 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH028348 GA Primary

Addresses

Primary practice location

1081 Ga Highway 96
Warner Robins, GA 31088-2507

Mailing address

205 Stacy LN
Warner Robins, GA 31088-1176

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

LicenseStateTypeSpecialty
RPH028348GAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1467223834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 STACY LN",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310881176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 GA HIGHWAY 96",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310882507",
            "telephone_number": "478-987-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADIWALA",
        "first_name": "TANVIBEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH028348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.