Individual provider Active NPI

Wesley V Waters III, PHARM.D., RPH

  • Pharmacist
  • Pittsboro, NC
National Provider Identifier
1083788343
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16414 Issued in NC
Practice address
628 East Street
Pittsboro, NC 27312
Phone
(910) 673-7467
Fax
(910) 673-3595
NPI assigned
Nov 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16414 NC Primary

Addresses

Primary practice location

628 East Street
Pittsboro, NC 27312

Mailing address

107 Thornhill Way
Aberdeen, NC 28315-3649
Phone (919) 444-1288

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
16414NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Compounding Pharmacy LLC Current Accepting new patients
Compounding Pharmacy LLC Current Accepting new patients
Person Street Pharmacy LLC Current Accepting new patients
Pittsboro Discount Drug, Inc Past Accepting new patients
Pittsboro Discount Drug, Inc Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083788343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 THORNHILL WAY",
            "city": "ABERDEEN",
            "state": "NC",
            "postal_code": "283153649",
            "telephone_number": "919-444-1288",
            "fax_number": "919-542-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 EAST STREET",
            "city": "PITTSBORO",
            "state": "NC",
            "postal_code": "27312",
            "telephone_number": "910-673-7467",
            "fax_number": "910-673-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "WESLEY",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHARM.D., RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "16414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.