Active NPI
Carol Vandiver Patterson
- Pharmacist
- Cleveland, GA
National Provider Identifier
1881001733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH017418
- Practice address
- 662 Highway 75 S
Cleveland, GA 30528-7183 - Phone
- (706) 219-2309
- NPI assigned
- Jul 11, 2014
- Last updated
- Jul 11, 2014
- Sex
- Female
- 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 | RPH017418 | GA | Primary |
Addresses
Primary practice location
662 Highway 75 S
Cleveland, GA 30528-7183
Mailing address
4557 Montclair Cir
Gainesville, GA 30506-5134
Phone (770) 983-2422
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 |
|---|---|---|---|
| RPH017418 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405036800000",
"number": "1881001733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4557 MONTCLAIR CIR",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305065134",
"telephone_number": "770-983-2422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "662 HIGHWAY 75 S",
"city": "CLEVELAND",
"state": "GA",
"postal_code": "305287183",
"telephone_number": "706-219-2309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "CAROL",
"middle_name": "VANDIVER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-11",
"last_updated": "2014-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH017418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, GA
- Xuan Thao Hoa Nguyen
- Northeast Georgia Physicians Group-Urgent Care, LLC
- O.W.a. Management Services, LLC (Cleveland Family Dental Center)
- Emily O'Bryant, PTA
- Meredith Palmer
- Peachtree Pharmacy Services
- Peachtree Pharmacy Services, L.L.C.
- Petitt Chiropractic Clinic; P.C.
- James Gregory Petitt, DC
- Janette Virginia Piedra, PT, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.