Active NPI
Marla Lynn Waters, PHARM D
- Pharmacist
- Jasper, GA
National Provider Identifier
1639761927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH023149
- Practice address
- 199 E Church St
Jasper, GA 30143-1301 - Phone
- (706) 253-9237
- NPI assigned
- Feb 8, 2021
- Last updated
- Jan 4, 2023
- Sex
- Female
- 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 | RPH023149 | GA | Primary |
Addresses
Primary practice location
199 E Church St
Jasper, GA 30143-1301
Mailing address
135 Laurel St
Canton, GA 30114-5870
Phone (770) 757-8060
Other names 1
- Marla Waters
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH023149 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672790400000",
"number": "1639761927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 LAUREL ST",
"city": "CANTON",
"state": "GA",
"postal_code": "301145870",
"telephone_number": "770-757-8060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "199 E CHURCH ST",
"city": "JASPER",
"state": "GA",
"postal_code": "301431301",
"telephone_number": "706-253-9237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "MARLA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-08",
"last_updated": "2023-01-04",
"certification_date": "2023-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH023149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARLA",
"last_name": "WATERS",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Jasper, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.