Active NPI
Mollianne Raynor
- Pharmacist
- Goldsboro, NC
National Provider Identifier
1053939975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29663
- Practice address
- 2202 Wayne Memorial Dr
Goldsboro, NC 27534-1724 - Phone
- (919) 739-5539
- NPI assigned
- Jul 7, 2020
- Last updated
- Sep 22, 2020
- Sex
- Female
- 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 | 29663 | NC | Primary |
Addresses
Primary practice location
2202 Wayne Memorial Dr
Goldsboro, NC 27534-1724
Mailing address
263 Falling Creek Church Rd
Goldsboro, NC 27530-9777
Phone (919) 920-7971
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29663 | NC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600732800000",
"number": "1053939975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 FALLING CREEK CHURCH RD",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275309777",
"telephone_number": "919-920-7971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2202 WAYNE MEMORIAL DR",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275341724",
"telephone_number": "919-739-5539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYNOR",
"first_name": "MOLLIANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-07",
"last_updated": "2020-09-22",
"certification_date": "2020-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "29663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goldsboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.