Active NPI
Chris J Deholl, PHARMD, BCNP
- Pharmacist
- Kernersville, NC
National Provider Identifier
1073965901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20203
- Practice address
- 409 N Main St
Kernersville, NC 27284-2643 - Phone
- (336) 993-2195
- NPI assigned
- Jul 3, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20203 | NC | Primary |
| Pharmacist | 183500000X | 010746 | SC |
Addresses
Primary practice location
409 N Main St
Kernersville, NC 27284-2643
Mailing address
108 Goldfinch Ave
Greensboro, NC 27409-9099
Phone (828) 505-6019
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 |
|---|---|---|---|
| 20203 | NC | MD | Genetic Counselor (M.S.) |
| 010746 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467504000000",
"number": "1073965901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 GOLDFINCH AVE",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274099099",
"telephone_number": "828-505-6019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 N MAIN ST",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272842643",
"telephone_number": "336-993-2195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEHOLL",
"first_name": "CHRIS",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PHARMD, BCNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-03",
"last_updated": "2016-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "20203",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "010746",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kernersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.