Active NPI
Charles Roberts II
- Pharmacist
- Lebanon, VA
National Provider Identifier
1083064836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202210749
- Practice address
- 597 Donald C. Moore Drive
Lebanon, VA 24266 - Phone
- (276) 254-9656
- NPI assigned
- Jun 13, 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 | 0202210749 | VA | Primary |
| Pharmacist | 183500000X | 0000036205 | TN |
Addresses
Primary practice location
597 Donald C. Moore Drive
Lebanon, VA 24266
Mailing address
597 Donald C. Moore Dr
Lebanon, VA 24266
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 |
|---|---|---|---|
| 0000036205 | TN | MD | Pharmacist |
| 0202210749 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465776000000",
"number": "1083064836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "597 DONALD C. MOORE DR",
"city": "LEBANON",
"state": "VA",
"postal_code": "24266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "597 DONALD C. MOORE DRIVE",
"city": "LEBANON",
"state": "VA",
"postal_code": "24266",
"telephone_number": "276-254-9656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "CHARLES",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-13",
"last_updated": "2016-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202210749",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "0000036205",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, VA
- RBM Opco of Lebanon LLC (Maple Grove Healthcare Center)
- Recovering Life PC
- Sharon T. Rice, MSED & MS
- Ride With Hope Sevices
- Jonathan Mark Ritchie, PHARMD
- Rodney H. McMurray LCSW Inc.
- Sarah Rose, MS CCC-SLP
- Russell County Clinic Corp (Lebanon Pediatrics)
- Russell County Clinic Corp
- Russell County Dental Clinic
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.