Active NPI
Tandraya Carpenter
- Pharmacist
- Peachtree City, GA
National Provider Identifier
1609493774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH031518
- Practice address
- 1200 Highway 74 S Ste 20
Peachtree City, GA 30269-3071 - Phone
- (770) 486-5559
- NPI assigned
- Jul 6, 2020
- 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 | RPH031518 | GA | Primary |
Addresses
Primary practice location
1200 Highway 74 S Ste 20
Peachtree City, GA 30269-3071
Mailing address
128 Stamford Ave
Peachtree City, GA 30269-6536
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 |
|---|---|---|---|
| RPH031518 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Publix Super Markets Inc | Past | Accepting new patients | |
| Publix Super Markets Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Publix Pharmacy #0799
- Community/Retail Pharmacy
- Peachtree City, GA
- NPI 1083653091
-
dba Publix Pharmacy #2107
- Community/Retail Pharmacy
- Winter Haven, FL
- NPI 1760356380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593993600000",
"number": "1609493774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 STAMFORD AVE",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302696536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 HIGHWAY 74 S STE 20",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302693071",
"telephone_number": "770-486-5559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARPENTER",
"first_name": "TANDRAYA",
"name_prefix": "Prof.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-06",
"last_updated": "2020-07-06",
"certification_date": "2020-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH031518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peachtree City, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.