Individual provider Active NPI

William Serafin Gonzalez, R.PH.

  • Pharmacist
  • Hiram, GA
National Provider Identifier
1972257020
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
015737 Issued in GA
Practice address
144 Bill Carruth Pkwy Ste 2000
Hiram, GA 30141-3822
Phone
(470) 644-8091
Fax
(470) 644-7353
NPI assigned
Feb 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 015737 GA Primary

Addresses

Primary practice location

144 Bill Carruth Pkwy Ste 2000
Hiram, GA 30141-3822

Mailing address

144 Bill Carruth Pkwy Ste 2000
Hiram, GA 30141-3822
Phone (470) 644-8091

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

State licenses

LicenseStateTypeSpecialty
015737GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Paulding Medical Center Inc PastSince Feb 13, 2022 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": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1972257020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 BILL CARRUTH PKWY STE 2000",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301413822",
            "telephone_number": "470-644-8091",
            "fax_number": "470-644-7353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 BILL CARRUTH PKWY STE 2000",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301413822",
            "telephone_number": "470-644-8091",
            "fax_number": "470-644-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "WILLIAM",
        "middle_name": "SERAFIN",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "015737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.