Individual provider Active NPI

Mary Ann McClucas, PHARM.D.

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1124149679
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPI000088 Issued in PA
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, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
30323NCMDPharmacist
RP439281PAMDPharmacist
RPI000088PAMDPharmacist

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.

Verify at the official NPI Registry.