Individual provider Active NPI

John Maldonado III, PHARMD.

  • Pharmacist
  • Gastonia, NC
National Provider Identifier
1083046296
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
23416 Issued in NC
Practice address
609 S New Hope Rd
Club Commons, Suite 200-B
Gastonia, NC 28054-4876
Phone
(480) 415-2646
NPI assigned
Jul 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 23416 NC Primary

Addresses

Primary practice location

609 S New Hope Rd
Club Commons, Suite 200-B
Gastonia, NC 28054-4876

Mailing address

609 S New Hope Rd
Club Commons, Suite 200-B
Gastonia, NC 28054-4876
Phone (480) 415-2646

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

LicenseStateTypeSpecialty
23416NCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1083046296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 S NEW HOPE RD",
            "address_2": "CLUB COMMONS, SUITE 200-B",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544876",
            "telephone_number": "480-415-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 S NEW HOPE RD",
            "address_2": "CLUB COMMONS, SUITE 200-B",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544876",
            "telephone_number": "480-415-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHARMD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "23416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.