Individual provider Active NPI

Melissa M Stephens, R.PH.

  • Pharmacist
  • Fayetteville, GA
National Provider Identifier
1790983153
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18000 Issued in GA
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

Updated by the provider on Feb 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.