Active NPI
Jeremy Hargis
- Pharmacist
- Grovetown, GA
National Provider Identifier
1477153666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH031249
- Practice address
- 5303A Wrightsboro Rd
Grovetown, GA 30813-2800 - Phone
- (762) 383-6527
- Fax
- (762) 383-6526
- NPI assigned
- Oct 28, 2020
- 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 | RPH031249 | GA | Primary |
Addresses
Primary practice location
5303A Wrightsboro Rd
Grovetown, GA 30813-2800
Mailing address
216 Oakhurst Dr
North Augusta, SC 29860-9718
Phone (803) 624-0620
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 |
|---|---|---|---|
| RPH031249 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Past | Accepting new patients | |
| Wal-Mart Stores East, LP | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1477153666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 OAKHURST DR",
"city": "NORTH AUGUSTA",
"state": "SC",
"postal_code": "298609718",
"telephone_number": "803-624-0620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5303A WRIGHTSBORO RD",
"city": "GROVETOWN",
"state": "GA",
"postal_code": "308132800",
"telephone_number": "762-383-6527",
"fax_number": "762-383-6526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARGIS",
"first_name": "JEREMY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-28",
"last_updated": "2020-10-28",
"certification_date": "2020-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH031249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grovetown, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.