Active NPI
Victor L Johnson, R.PH.
- Pharmacist
- Evans, GA
National Provider Identifier
1497004873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14405
- Practice address
- 4571 Oxford Dr
Evans, GA 30809-3843 - Phone
- (706) 868-9965
- NPI assigned
- Aug 31, 2012
- Last updated
- Aug 31, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14405 | GA | Primary |
| Pharmacist | 183500000X | PS21353 | FL | |
| Pharmacist | 183500000X | 9987 | SC | |
| Pharmacist | 183500000X | 14824 | NC |
Addresses
Primary practice location
4571 Oxford Dr
Evans, GA 30809-3843
Mailing address
4571 Oxford Drive
Evans, GA 30809
Phone (706) 868-9965
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS21353 | FL | MD | Pharmacist |
| 14824 | NC | MD | Pharmacist |
| 9987 | SC | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rutmel, Inc | Current | 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": "1346371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346371200000",
"number": "1497004873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4571 OXFORD DRIVE",
"city": "EVANS",
"state": "GA",
"postal_code": "30809",
"telephone_number": "706-868-9965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4571 OXFORD DR",
"city": "EVANS",
"state": "GA",
"postal_code": "308093843",
"telephone_number": "706-868-9965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "VICTOR",
"middle_name": "L",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-31",
"last_updated": "2012-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "14405",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS21353",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "9987",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "14824",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evans, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.