Individual provider Active NPI

Nicole Bateham

  • Pharmacist
  • Kennesaw, GA
National Provider Identifier
1700717451
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
034125 Issued in GA
Practice address
3895 Cherokee St NW
Kennesaw, GA 30144-6727
Phone
(770) 218-7033
NPI assigned
May 28, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 034125 GA Primary

Addresses

Primary practice location

3895 Cherokee St NW
Kennesaw, GA 30144-6727

Mailing address

3895 Cherokee St NW
Kennesaw, GA 30144-6727
Phone (770) 218-7033

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

LicenseStateTypeSpecialty
034125GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Co 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1779926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1700717451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3895 CHEROKEE ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446727",
            "telephone_number": "770-218-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3895 CHEROKEE ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446727",
            "telephone_number": "770-218-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATEHAM",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-28",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "034125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.