Active NPI
Chickham Syvanthong, PHARM.D.
- Pharmacist
- Charlotte, NC
National Provider Identifier
1033412556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16890
- Practice address
- 8220 Mount Holly Huntersville Rd
Charlotte, NC 28216-9744 - Phone
- (704) 399-5303
- NPI assigned
- Dec 7, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16890 | NC | Primary |
Addresses
Primary practice location
8220 Mount Holly Huntersville Rd
Charlotte, NC 28216-9744
Mailing address
8220 Mount Holly Huntersville Rd
Charlotte, NC 28216-9744
Phone (704) 399-5303
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 |
|---|---|---|---|
| 16890 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients | |
| North Carolina CVS Pharmacy, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291680000000",
"number": "1033412556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8220 MOUNT HOLLY HUNTERSVILLE RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282169744",
"telephone_number": "704-399-5303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8220 MOUNT HOLLY HUNTERSVILLE RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282169744",
"telephone_number": "704-399-5303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYVANTHONG",
"first_name": "CHICKHAM",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-12-07",
"last_updated": "2010-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "16890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.