Burgandy Ann Payne

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

RPH032154 Issued in GA

Practice address

430 N 3Rd Ave
Chatsworth, GA 30705-2540

Phone

(706) 695-0444

Fax

(706) 517-5157

NPI assigned

Aug 21, 2020

Last updated

Aug 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wellpharm LLC

  dba Cherokee Custom Script Pharmacy

  • Pharmacist
  • Canton, GA
  • NPI 1104960202
  NPD (past)

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1912519745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 PAYNE RD",
            "city": "DELANO",
            "state": "TN",
            "postal_code": "373257027",
            "telephone_number": "423-715-7592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N 3RD AVE",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052540",
            "telephone_number": "706-695-0444",
            "fax_number": "706-517-5157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2260 Holly Springs Pkwy Ste 180",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301159580",
            "country_code": "US",
            "telephone_number": "770-704-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "BURGANDY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "GA",
            "license": "RPH032154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myeyedr Optometry of Georgia, LLC (MyEyeDr.)
• Nightfall Medical LLC
• Laura Huber Nix, ARPN, NP-C
• Kimberly Noland, DMD
• NW Georgia Eye Care
• Alison Peden, NP
• Amanda Brooke Peeples, RN, BSN
• Karen Penland, RN
• Dejah Rena Perry, FNP-BC
• Personal Family Care, P.C

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Chatsworth, GA
• Providers in Chatsworth, GA by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.