Individual provider Active NPI

John Davie Waggett, RPH

  • Pharmacist
  • Wilmington, NC
National Provider Identifier
1164542452
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
7169 Issued in NC
Practice address
2059 Carolina Beach Rd
Wilmington, NC 28401-7239
Phone
(910) 762-6278
Fax
(910) 343-0710
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7169 NC Primary

Addresses

Primary practice location

2059 Carolina Beach Rd
Wilmington, NC 28401-7239

Mailing address

612 Bayshore Dr
Wilmington, NC 28411-9419
Phone (910) 686-1661

Other identifiers 1

IdentifierTypeStateIssuer
7169OtherNCBOARD OF PHARMACY

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
7169NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Seashore Discount Drugs, Inc Current Accepting new patients
Seashore Drugs Inc Current Accepting new patients

Locations

2059 Carolina Beach Rd
Wilmington, NC 28401
Phone (910) 762-6278

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164542452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 BAYSHORE DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119419",
            "telephone_number": "910-686-1661",
            "fax_number": "910-686-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2059 CAROLINA BEACH RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017239",
            "telephone_number": "910-762-6278",
            "fax_number": "910-343-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGETT",
        "first_name": "JOHN",
        "middle_name": "DAVIE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "7169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "7169",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.