Jacob Allan Decamp, RPH

Primary specialty

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

License

RPH032931 Issued in GA

Practice address

3200 Holcomb Bridge Rd
Peachtree Corners, GA 30092-3361

Phone

(770) 417-5106

NPI assigned

Jul 1, 2021

Sex

Male

Sole proprietor

No

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

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1962072801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 RALPH MCGILL BLVD NE UNIT 1259",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121136",
            "telephone_number": "678-865-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 HOLCOMB BRIDGE RD",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300923361",
            "telephone_number": "770-417-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECAMP",
        "first_name": "JACOB",
        "middle_name": "ALLAN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "GA",
            "license": "RPH032931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Cummings
• Sam Daliri, D.M.D
• Samuel Dameus
• Charney Davis, LCSW
• Kristina Mohme Dawson, D.M.D.
• Vakitre Denson
• Lori Desoutter, M.D.
• Linh DO
• Alice T Dorking, CCC-SLP
• Dr. John S Yu and Associates P.C.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Peachtree Corners, GA
• Providers in Peachtree Corners, 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 Jul 1, 2021; 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.