Active NPI
Bernice Roberts, RPH
- Pharmacist
- McDonough, GA
National Provider Identifier
1508156621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH012704
- Practice address
- 2125 Highway 155 N
McDonough, GA 30252-4809 - Phone
- (678) 583-5592
- Fax
- (678) 583-1257
- NPI assigned
- Apr 11, 2011
- Last updated
- Apr 11, 2011
- 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 | RPH012704 | GA | Primary |
Addresses
Primary practice location
2125 Highway 155 N
McDonough, GA 30252-4809
Mailing address
665 Austin Rd
Ellenwood, GA 30294-3221
Phone (404) 219-5605
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 |
|---|---|---|---|
| RPH012704 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302480000000",
"number": "1508156621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "665 AUSTIN RD",
"city": "ELLENWOOD",
"state": "GA",
"postal_code": "302943221",
"telephone_number": "404-219-5605",
"fax_number": "678-583-1257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2125 HIGHWAY 155 N",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302524809",
"telephone_number": "678-583-5592",
"fax_number": "678-583-1257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "BERNICE",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-11",
"last_updated": "2011-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH012704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McDonough, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.