Individual provider Active NPI

Adebisi Adeniyi, PHARM.D.

  • Pharmacist
  • Covington, GA
National Provider Identifier
1629672134
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH031585 Issued in GA
Practice address
5384 Highway 20 S
Covington, GA 30016-4403
Phone
(770) 788-6566
NPI assigned
Nov 24, 2020
Last updated
Nov 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH031585 GA Primary

Addresses

Primary practice location

5384 Highway 20 S
Covington, GA 30016-4403

Mailing address

204 James Forest CT
Stockbridge, GA 30281-1479
Phone (678) 613-2826

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH031585GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia CVS Pharmacy L.L.C PastSince Nov 29, 2020 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": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1629672134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 JAMES FOREST CT",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302811479",
            "telephone_number": "678-613-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5384 HIGHWAY 20 S",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300164403",
            "telephone_number": "770-788-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADENIYI",
        "first_name": "ADEBISI",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH031585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.

Verify at the official NPI Registry.