Individual provider Active NPI

Deangelo Demond King, PHARMD

  • Pharmacist
  • Smithfield, NC
National Provider Identifier
1083250617
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28948 Issued in NC
Practice address
424 N Brightleaf Blvd
Smithfield, NC 27577-4674
Phone
(919) 989-4058
NPI assigned
Nov 19, 2019
Last updated
Nov 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28948 NC Primary

Addresses

Primary practice location

424 N Brightleaf Blvd
Smithfield, NC 27577-4674

Mailing address

900 E Six Forks Rd Unit 324
Raleigh, NC 27604-1838

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
28948NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1083250617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E SIX FORKS RD UNIT 324",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 N BRIGHTLEAF BLVD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774674",
            "telephone_number": "919-989-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "DEANGELO",
        "middle_name": "DEMOND",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "28948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.

Verify at the official NPI Registry.