Active NPI
Dwight Anthony Medlin, PHARMACIST RPH
- Pharmacist
- Jacksonville, NC
National Provider Identifier
1053480681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13318
- Practice address
- 714 New Bridge St
Jacksonville, NC 28540 - Phone
- (910) 347-5185
- Fax
- (910) 347-9298
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 13318 | NC | Primary |
Addresses
Primary practice location
714 New Bridge St
Jacksonville, NC 28540
Mailing address
182 Leas Lane
Hampstead, NC 28443
Phone (910) 270-3512
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13318 | NC | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053480681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "182 LEAS LANE",
"city": "HAMPSTEAD",
"state": "NC",
"postal_code": "28443",
"telephone_number": "910-270-3512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 NEW BRIDGE ST",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "28540",
"telephone_number": "910-347-5185",
"fax_number": "910-347-9298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDLIN",
"first_name": "DWIGHT",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"credential": "PHARMACIST RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "13318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.