Individual provider Active NPI

Maria Ayala Sesan

  • Pharmacist
  • Kennesaw, GA
National Provider Identifier
1740884196
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH029524 Issued in GA
Practice address
2782 N Cobb Pkwy
Kennesaw, GA 30152-3472
Phone
(770) 420-1092
NPI assigned
Nov 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH029524 GA Primary

Addresses

Primary practice location

2782 N Cobb Pkwy
Kennesaw, GA 30152-3472

Mailing address

3905 Butterstream Way NW
Kennesaw, GA 30144-5711
Phone (678) 896-2614

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
RPH029524GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1740884196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 BUTTERSTREAM WAY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445711",
            "telephone_number": "678-896-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2782 N COBB PKWY",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523472",
            "telephone_number": "770-420-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SESAN",
        "first_name": "MARIA",
        "middle_name": "AYALA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH029524",
            "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 Nov 25, 2020; 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.