Individual provider Active NPI

Jarvis Alexander Perry, PHARMD

  • Pharmacist
  • Union City, GA
National Provider Identifier
1669104758
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH033553 Issued in GA
Practice address
4617 Jonesboro Rd
Union City, GA 30291-2048
Phone
(770) 969-7458
NPI assigned
Jun 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH033553 GA Primary

Addresses

Primary practice location

4617 Jonesboro Rd
Union City, GA 30291-2048

Mailing address

634 Roy Huie Rd Apt 12E
Riverdale, GA 30274-1743
Phone (770) 377-2365

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
RPH033553GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Jul 3, 2022 Accepting new patients
Walgreen Co PastSince Jul 3, 2022 Accepting new patients

Locations

4617 Jonesboro Rd
Union City, GA 30291
Phone (770) 969-7458

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1669104758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 ROY HUIE RD APT 12E",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302741743",
            "telephone_number": "770-377-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 JONESBORO RD",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912048",
            "telephone_number": "770-969-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JARVIS",
        "middle_name": "ALEXANDER",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH033553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.