Individual provider Active NPI

William Douglas Mitchell, RPH

  • Pharmacist
  • Fayetteville, NC
National Provider Identifier
1144557992
Registry record updated Nov 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6692 Issued in NC
Practice address
3296 Village Dr
Fayetteville, NC 28304-3817
Phone
(910) 433-4681
Fax
(910) 433-2892
NPI assigned
Nov 14, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6692 NC Primary

Addresses

Primary practice location

3296 Village Dr
Fayetteville, NC 28304-3817

Mailing address

510 Hilliard Dr
Fayetteville, NC 28311-2677
Phone (910) 433-4681

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
6692NCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co 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.

NPI Registry JSON

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

{
    "created_epoch": "1258156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258156800000",
    "number": "1144557992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HILLIARD DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283112677",
            "telephone_number": "910-433-4681",
            "fax_number": "910-433-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3296 VILLAGE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043817",
            "telephone_number": "910-433-4681",
            "fax_number": "910-433-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "WILLIAM",
        "middle_name": "DOUGLAS",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-14",
        "last_updated": "2009-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "6692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2009; 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.