Individual provider Active NPI

Christelle Pouani Kouemo

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1104395029
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
27954 Issued in NC
Practice address
9816 Rocky Ford Club Rd
Charlotte, NC 28269-2860
Phone
(704) 773-7781
NPI assigned
Nov 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 27954 NC Primary

Addresses

Primary practice location

9816 Rocky Ford Club Rd
Charlotte, NC 28269-2860

Mailing address

9816 Rocky Ford Club Rd
Charlotte, NC 28269-2860
Phone (704) 773-7781

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

LicenseStateTypeSpecialty
27954NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1104395029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9816 ROCKY FORD CLUB RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282692860",
            "telephone_number": "704-773-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9816 ROCKY FORD CLUB RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282692860",
            "telephone_number": "704-773-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUEMO",
        "first_name": "CHRISTELLE",
        "middle_name": "POUANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "27954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.