Active NPI
Mary Ann McClucas, PHARM.D.
- Pharmacist
- Charlotte, NC
National Provider Identifier
1124149679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPI000088
- Practice address
- 7735 N Tryon St
Charlotte, NC 28262-3498 - Phone
- (704) 547-0972
- Fax
- (704) 548-8369
- NPI assigned
- Apr 3, 2007
- Last updated
- Oct 31, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 30323 | NC | |
| Pharmacist | 183500000X | RP439281 | PA | |
| Pharmacist | 183500000X | RPI000088 | PA | Primary |
Addresses
Primary practice location
7735 N Tryon St
Charlotte, NC 28262-3498
Mailing address
607 Baucom Deese Rd
Monroe, NC 28110-8782
Phone (814) 233-9336
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 |
|---|---|---|---|
| 30323 | NC | MD | Pharmacist |
| RP439281 | PA | MD | Pharmacist |
| RPI000088 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1124149679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 BAUCOM DEESE RD",
"city": "MONROE",
"state": "NC",
"postal_code": "281108782",
"telephone_number": "814-233-9336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7735 N TRYON ST",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282623498",
"telephone_number": "704-547-0972",
"fax_number": "704-548-8369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLUCAS",
"first_name": "MARY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "30323",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP439281",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RPI000088",
"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 Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.