Active NPI
Melissa M Stephens, R.PH.
- Pharmacist
- Fayetteville, GA
National Provider Identifier
1790983153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18000
- Practice address
- 805 Glynn St S
Fayetteville, GA 30214-2000 - Phone
- (770) 461-8266
- NPI assigned
- Jul 6, 2007
- 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 | 18000 | GA | Primary |
Addresses
Primary practice location
805 Glynn St S
Fayetteville, GA 30214-2000
Mailing address
805 Glynn St S
Fayetteville, GA 30214-2000
Phone (770) 461-8266
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
- Registered Pharmacist
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The 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.
-
- Community/Retail Pharmacy
- Fayetteville, GA
- NPI 1134153042
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330473600000",
"number": "1790983153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 GLYNN ST S",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302142000",
"telephone_number": "770-461-8266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 GLYNN ST S",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302142000",
"telephone_number": "770-461-8266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "MELISSA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-06",
"last_updated": "2012-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "18000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.