Individual provider Active NPI

Rondell Clayton Jaggers, PHARMD

  • Pharmacist
  • Atlanta, GA
National Provider Identifier
1831199249
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH019882 Issued in GA
Practice address
80 Jesse Hill Jr Dr SE
Grady Health System Pharmacy
Atlanta, GA 30303-3031
Phone
(404) 616-3141
Fax
(404) 616-6070
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH019882 GA Primary

Addresses

Primary practice location

80 Jesse Hill Jr Dr SE
Grady Health System Pharmacy
Atlanta, GA 30303-3031

Mailing address

3260 Millwood TRL SE
Smyrna, GA 30080-1602
Phone (678) 556-9573

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH019882GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1831199249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 MILLWOOD TRL SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300801602",
            "telephone_number": "678-556-9573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "address_2": "GRADY HEALTH SYSTEM PHARMACY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-3141",
            "fax_number": "404-616-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGGERS",
        "first_name": "RONDELL",
        "middle_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH019882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.