Active NPI
Talmadge R Green, P.D.
- Pharmacist
- Alexandria, LA
National Provider Identifier
1760564439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11049
- Practice address
- 1414 Jackson St
Alexandria, LA 71301-6931 - Phone
- (318) 442-4485
- Fax
- (318) 443-6410
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- 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 | 11049 | LA | Primary |
Addresses
Primary practice location
1414 Jackson St
Alexandria, LA 71301-6931
Mailing address
1414 Jackson St
Alexandria, LA 71301-6931
Phone (318) 442-4485
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1234869 | Medicaid | LA | |
| 914-IR | Other | LA | LA PHARMACY PERMIT NO. |
| 1903360 | Other | NABP |
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 |
|---|---|---|---|
| 11049 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Pharmacy RX, LLC | 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.
-
- Community/Retail Pharmacy
- Alexandria, LA
- NPI 1689030686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423180800000",
"number": "1760564439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 JACKSON ST",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713016931",
"telephone_number": "318-442-4485",
"fax_number": "318-443-6410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 JACKSON ST",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713016931",
"telephone_number": "318-442-4485",
"fax_number": "318-443-6410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "TALMADGE",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "P.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2015-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "11049",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1234869",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LA PHARMACY PERMIT NO.",
"identifier": "914-IR",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "1903360",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.