Active NPI
Nneka Anuli Izundu, PHARM MD
- Pharmacist
- Stone Mountain, GA
National Provider Identifier
1740563170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH021215
- Practice address
- 5320 Memorial Dr
Stone Mountain, GA 30083-3201 - Phone
- (404) 508-7166
- NPI assigned
- Sep 22, 2011
- Sex
- Female
- 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 | RPH021215 | GA | Primary |
Addresses
Primary practice location
5320 Memorial Dr
Stone Mountain, GA 30083-3201
Mailing address
1474 Wild Rye LN
Grayson, GA 30017-4198
Phone (404) 547-1735
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 Medicine, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH021215 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1740563170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1474 WILD RYE LN",
"city": "GRAYSON",
"state": "GA",
"postal_code": "300174198",
"telephone_number": "404-547-1735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5320 MEMORIAL DR",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300833201",
"telephone_number": "404-508-7166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IZUNDU",
"first_name": "NNEKA",
"middle_name": "ANULI",
"name_prefix": "Dr.",
"credential": "PHARM MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-22",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH021215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stone Mountain, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.