Individual provider Active NPI

Ryan Smith, RPH

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1164963021
Registry record updated Mar 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15027 Issued in NC
Practice address
3240 Wilkinson Blvd
Charlotte, NC 28208-5630
Phone
(704) 392-7282
NPI assigned
Mar 12, 2017
Last updated
Mar 12, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15027 NC Primary

Addresses

Primary practice location

3240 Wilkinson Blvd
Charlotte, NC 28208-5630

Mailing address

2930 Barnard Castle LN
Matthews, NC 28104-1188
Phone (704) 882-3531

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
15027NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1489276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489276800000",
    "number": "1164963021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 BARNARD CASTLE LN",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281041188",
            "telephone_number": "704-882-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 WILKINSON BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282085630",
            "telephone_number": "704-392-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RYAN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-12",
        "last_updated": "2017-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "15027",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 12, 2017; 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.