NPI age
4 years
Enumerated 2021-06-24
● Active
Type 1 · Individual
Kenneth Fanning
Fanning is 1 of 5 pharmacist providers in Saint Marys and 1 of 8384 in Georgia.
Primary specialty
Pharmacist
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2021-07-27
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 8384 active pharmacist providers in Georgia.
NPI age
4 years
↓ 5 yr below median (9 yr)
State licenses
1 state
9% of peers hold multiple states
Subspecialties
0
10% of peers hold subspecialties
NPI lifetime · 2021 → 2026
2021-06Enumerated in NPPES
2021
2026
Where they practice
Practice location
555 Charlie Smith SR Hwy
Saint Marys, GA 315583030
Mailing address
1536 N Market St
Jacksonville, FL 322064540
Specialties
-
Pharmacist PrimaryAn individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation,...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.