Individual provider Active NPI

Kevin Levesque

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1154549970
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19322 Issued in NC
Practice address
1830 Galleria Blvd.
Charlotte, NC 28270
Phone
(704) 841-1865
Fax
(714) 841-1394
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PR4851 ME
Pharmacist 183500000X 19322 NC Primary

Addresses

Primary practice location

1830 Galleria Blvd.
Charlotte, NC 28270

Mailing address

2501 Carriage Crossing Dr
Matthews, NC 28105-8827
Phone (704) 841-1865

Other identifiers 2

IdentifierTypeStateIssuer
19322OtherNCNC BOARD OF PHARMACY
PR4851OtherMEPHARMACIST LICENSE

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
PR4851MEMDPharmacist
19322NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1154549970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CARRIAGE CROSSING DR",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281058827",
            "telephone_number": "704-841-1865",
            "fax_number": "714-841-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 GALLERIA BLVD.",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28270",
            "telephone_number": "704-841-1865",
            "fax_number": "714-841-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVESQUE",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR4851",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "19322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BOARD OF PHARMACY",
            "identifier": "19322",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PR4851",
            "state": "ME"
        }
    ],
    "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 Jul 31, 2014; 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.