Active NPI
Alexa Noelle Dodson Bancroft
- Pharmacist
- Athens, TN
National Provider Identifier
1700550753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 45131
- Practice address
- 1114 W Madison Ave
Athens, TN 37303-4150 - Phone
- (423) 745-1411
- NPI assigned
- Aug 3, 2021
- Last updated
- Aug 3, 2021
- 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 | 45131 | TN | Primary |
Addresses
Primary practice location
1114 W Madison Ave
Athens, TN 37303-4150
Mailing address
1114 Tomahawk Cir NW
Cleveland, TN 37312-3462
Phone (423) 284-9616
Other practice location 1
5301 Ringgold Rd
East Ridge, TN 37412-3125
Phone (423) 892-9559
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | N/A |
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 |
|---|---|---|---|
| 45131 | TN | MD | Pediatrics Physician |
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": "1627948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627948800000",
"number": "1700550753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1114 TOMAHAWK CIR NW",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373123462",
"telephone_number": "423-284-9616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1114 W MADISON AVE",
"city": "ATHENS",
"state": "TN",
"postal_code": "373034150",
"telephone_number": "423-745-1411"
}
],
"practiceLocations": [
{
"address_1": "5301 Ringgold Rd",
"address_purpose": "LOCATION",
"city": "East Ridge",
"state": "TN",
"postal_code": "374123125",
"country_code": "US",
"telephone_number": "423-892-9559",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BANCROFT",
"first_name": "ALEXA",
"middle_name": "NOELLE DODSON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-03",
"last_updated": "2021-08-03",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "45131",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "N/A",
"affiliation": "N",
"address_1": "5301 Ringgold Rd",
"city": "East Ridge",
"state": "TN",
"country_code": "US",
"postal_code": "374123125",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Athens, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.