Active NPI
Dorothy Ravenell
- Pharmacist
- Waxhaw, NC
National Provider Identifier
1124461090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18198
- Practice address
- 8100 Soaring Eagle LN
Waxhaw, NC 28173-7495 - Phone
- (704) 843-5853
- NPI assigned
- Apr 10, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18198 | NC | Primary |
Addresses
Primary practice location
8100 Soaring Eagle LN
Waxhaw, NC 28173-7495
Mailing address
8100 Soaring Eagle LN
Waxhaw, NC 28173-7495
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18198 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365552000000",
"number": "1124461090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8100 SOARING EAGLE LN",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281737495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8100 SOARING EAGLE LN",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281737495",
"telephone_number": "704-843-5853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAVENELL",
"first_name": "DOROTHY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-10",
"last_updated": "2013-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "18198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waxhaw, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.