NPIMap

Individual provider Active NPI

Lori Kodikara, RPH

  • Pharmacist
  • Locust, NC
National Provider Identifier
1164838652
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11858 Issued in NC
Practice address
1876 Main St W
Locust, NC 28097-7700
Phone
(704) 781-0574
Fax
(704) 781-0575
NPI assigned
Jul 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11858 NC Primary

Addresses

Primary practice location

1876 Main St W
Locust, NC 28097-7700

Mailing address

1876 Main St W
Locust, NC 28097-7700
Phone (704) 781-0574

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
11858NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East, LP Past Accepting new patients
Wal-Mart Stores East LP 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": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404691200000",
    "number": "1164838652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1876 MAIN ST W",
            "city": "LOCUST",
            "state": "NC",
            "postal_code": "280977700",
            "telephone_number": "704-781-0574",
            "fax_number": "704-781-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1876 MAIN ST W",
            "city": "LOCUST",
            "state": "NC",
            "postal_code": "280977700",
            "telephone_number": "704-781-0574",
            "fax_number": "704-781-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODIKARA",
        "first_name": "LORI",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "11858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Locust, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.