Active NPI
Ivy Jackie Sanders
- Pharmacy Technician
- Wilson, NC
National Provider Identifier
1164713426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 28514
- Practice address
- 4761 Ward Blvd
Wilson, NC 27893-4359 - Phone
- (252) 399-2112
- Fax
- (252) 399-2136
- NPI assigned
- Apr 21, 2011
- Last updated
- Apr 21, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 28514 | NC | Primary |
Addresses
Primary practice location
4761 Ward Blvd
Wilson, NC 27893-4359
Mailing address
4761 Ward Blvd
Wilson, NC 27893-4359
Phone (252) 399-2112
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 |
|---|---|---|---|
| 28514 | NC | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303344000000",
"number": "1164713426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4761 WARD BLVD",
"city": "WILSON",
"state": "NC",
"postal_code": "278934359",
"telephone_number": "252-399-2112",
"fax_number": "252-399-2136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4761 WARD BLVD",
"city": "WILSON",
"state": "NC",
"postal_code": "278934359",
"telephone_number": "252-399-2112",
"fax_number": "252-399-2136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "IVY",
"middle_name": "JACKIE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-21",
"last_updated": "2011-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "NC",
"license": "28514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.