Active NPI
Charles Berry
- Pharmacist
- Ridgeland, MS
National Provider Identifier
1073162293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E06487
- Practice address
- 680 Highway 51 Ste G
Ridgeland, MS 39157-2103 - Phone
- (601) 853-4611
- NPI assigned
- Sep 10, 2019
- Last updated
- Sep 10, 2019
- 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 | E06487 | MS | Primary |
Addresses
Primary practice location
680 Highway 51 Ste G
Ridgeland, MS 39157-2103
Mailing address
113 Commons PL
Ridgeland, MS 39157-8667
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 |
|---|---|---|---|
| E06487 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Service Drugs LLC | Current | Accepting new patients | |
| Shields Drugs Inc | Past | Accepting new patients |
Locations
680 Highway 51
Ste G
Ridgeland, MS 39157
Phone (601) 853-4611
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Ridgeland, MS
- NPI 1902517733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568073600000",
"number": "1073162293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 COMMONS PL",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391578667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 HIGHWAY 51 STE G",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391572103",
"telephone_number": "601-853-4611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "CHARLES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-10",
"last_updated": "2019-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E06487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgeland, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.