Active NPI
Cecil Manning Davis, PHARM.D
- Geriatric Pharmacist
- Kernersville, NC
National Provider Identifier
1104029602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Pharmacist
- License
- 11736
- Practice address
- 1031 E Mountain St BLDG 319
Kernersville, NC 27284-7998 - Phone
- (336) 904-1760
- Fax
- (866) 928-3983
- NPI assigned
- Jun 11, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 11736 | NC | Primary |
Addresses
Primary practice location
1031 E Mountain St BLDG 319
Kernersville, NC 27284-7998
Mailing address
1031 E Mountain St
Kernersville, NC 27284-7997
Phone (336) 904-1760
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 |
|---|---|---|---|
| 11736 | NC | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guardian Pharmacy of Eastern NC, LLC | Past | Accepting new patients | |
| Guardian Pharmacy of Eastern NC, LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Long Term Care Pharmacy
- Kernersville, NC
- NPI 1730478827
-
- Long Term Care Pharmacy
- Pink Hill, NC
- NPI 1821387911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580428800000",
"number": "1104029602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1031 E MOUNTAIN ST",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272847997",
"telephone_number": "336-904-1760",
"fax_number": "866-928-3983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1031 E MOUNTAIN ST BLDG 319",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272847998",
"telephone_number": "336-904-1760",
"fax_number": "866-928-3983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "CECIL",
"middle_name": "MANNING",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-11",
"last_updated": "2020-01-31",
"certification_date": "2020-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "NC",
"license": "11736",
"primary": true
}
],
"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 Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.