VENITA PETERSON (NPI# 1720686207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720686207 |
| Entity Type | Individual |
| Full Name | VENITA PETERSON |
| Practice Address |
8059 Tara Blvd Jonesboro GA 30236-3293 |
| Mailing Address |
456 Sora Dr Stockbridge GA 30281-2288 |
| Practice Telephone | 7704786353 |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
26019793A | IN | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
020634 | GA | Pharmacy Service Providers |
| Street Address |
8059 TARA BLVD |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236-3293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215952098 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 8059 Tara Blvd, Jonesboro, GA 30236-3293 | 2006-07-13 |
| 1902407653 | Jozetta Dejean | Pharmacist | 8059 Tara Blvd, Jonesboro, GA 30236-3293 | 2020-11-07 |
| 1669002986 | April Abreu | Pharmacist | 8059 Tara Blvd, Jonesboro, GA 30236-3293 | 2020-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407653 | Jozetta Dejean | Pharmacist | 8059 Tara Blvd, Jonesboro, GA 30236-3293 | 2020-11-07 |
| 1669002986 | April Abreu | Pharmacist | 8059 Tara Blvd, Jonesboro, GA 30236-3293 | 2020-01-26 |
| 1275813628 | Niama Janese Natara Brown | Pharmacist | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2011-08-17 |
| 1316189202 | John Thomas Frank | Pharmacist | 223 E Jackson Ave, Jonesboro, AR 72401-3119 | 2009-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445747 | Hiep Hoang Do | Pharmacist | 801 Burns Estates Dr, Lilburn, GA 30047-3484 | 2020-10-17 |
| 1518565902 | Edward Edeh | Pharmacist | 1232 South Hairstoh Road, Stone Mountain, GA 30088 | 2020-10-16 |
| 1548868342 | Jackson Gathuru Ngugi | Pharmacist | 193 Anniversary Ln, Acworth, GA 30102-2045 | 2020-10-14 |
| 1568086494 | Lynn Berner Marshall | Pharmacist | 3823 Club Forest Dr, Peachtree Corners, GA 30092-2369 | 2020-06-06 |
| 1295357325 | Rhonda Ireland | Pharmacist | 125 Main Street Marketplace, Cartersville, GA 30120 | 2020-05-12 |
| 1073132676 | Khushboo S Rhodes | Pharmacist | 3101 Roswell Rd Ste 132, Marietta, GA 30062-5523 | 2020-04-14 |
| 1194354647 | Deanna W Mcewen | Pharmacist | 1720 Epps Bridge Road, Athens, GA 30606-6132 | 2020-04-06 |
| 1104452663 | Latrena Solomon | Pharmacist | 1750 Highway 138 E, Stockbridge, GA 30281-2810 | 2020-03-17 |
| 1497389597 | Rx Healthcare Ltd | Pharmacist | 2136 W Park Ct Ste I, Stone Mountain, GA 30087-3528 | 2020-02-27 |
| 1972136273 | Shannon Sulik | Pharmacist | 774 Highway 96, Bonaire, GA 31005-3300 | 2020-02-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.