Active NPI
Daniel Michael Tootle, RPH
- Pharmacist
- Claxton, GA
National Provider Identifier
1659489490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12310
- Practice address
- 305 E Long St
Claxton, GA 30417-1411 - Phone
- (912) 739-9393
- Fax
- (912) 739-9033
- NPI assigned
- Aug 29, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12310 | GA | Primary |
Addresses
Primary practice location
305 E Long St
Claxton, GA 30417-1411
Mailing address
PO Box 577
Claxton, GA 30417-0577
Phone (912) 739-9393
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 |
|---|---|---|---|
| 12310 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| His Care LLC | Past | 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": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659489490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 577",
"city": "CLAXTON",
"state": "GA",
"postal_code": "304170577",
"telephone_number": "912-739-9393",
"fax_number": "912-739-9033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 E LONG ST",
"city": "CLAXTON",
"state": "GA",
"postal_code": "304171411",
"telephone_number": "912-739-9393",
"fax_number": "912-739-9033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOOTLE",
"first_name": "DANIEL",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "12310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Claxton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.