Active NPI
Tobin Pottas Jacob, PHARMD
- Pharmacist
- Suwanee, GA
National Provider Identifier
1982999421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH024917
- Practice address
- 2625 Peachtree Pkwy
T-2056
Suwanee, GA 30024-1048 - Phone
- (678) 965-5806
- Fax
- (678) 965-5806
- NPI assigned
- Jun 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH024917 | GA | Primary |
| Pharmacist | 183500000X | PS46148 | FL |
Addresses
Primary practice location
2625 Peachtree Pkwy
T-2056
Suwanee, GA 30024-1048
Mailing address
2625 Peachtree Pkwy
T-2056
Suwanee, GA 30024-1048
Phone (678) 965-5806
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS46148 | FL | MD | Pharmacist |
| RPH024917 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307923200000",
"number": "1982999421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 PEACHTREE PKWY",
"address_2": "T-2056",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300241048",
"telephone_number": "678-965-5806",
"fax_number": "678-965-5806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 PEACHTREE PKWY",
"address_2": "T-2056",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300241048",
"telephone_number": "678-965-5806",
"fax_number": "678-965-5806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "TOBIN",
"middle_name": "POTTAS",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-13",
"last_updated": "2011-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH024917",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS46148",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.