Individual provider Active NPI

Andrea Renae Hensley, PHARMD

  • Pharmacist
  • Charleston, WV
National Provider Identifier
1174959159
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP0007938 Issued in WV
Practice address
4205 Maccorkle Ave SE
Charleston, WV 25304-2501
Phone
(304) 925-0786
NPI assigned
Sep 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 22910 NC
Pharmacist 183500000X RP0007938 WV Primary

Addresses

Primary practice location

4205 Maccorkle Ave SE
Charleston, WV 25304-2501

Mailing address

415 Rock Holly Rd
Charleston, WV 25314-1535
Phone (304) 588-0036

Other practice location 1

704 S Memorial Dr
Greenville, NC 27834-3738
Phone (252) 758-4104

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL CVS Direct

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
22910NCMDPharmacist
RP0007938WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia CVS Pharmacy LLC PastSince Oct 11, 2020 Accepting new patients
West Virginia CVS Pharmacy LLC PastSince Oct 11, 2020 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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1174959159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 ROCK HOLLY RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141535",
            "telephone_number": "304-588-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042501",
            "telephone_number": "304-925-0786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 S Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278343738",
            "country_code": "US",
            "telephone_number": "252-758-4104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENSLEY",
        "first_name": "ANDREA",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "22910",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0007938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CVS",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4205 MacCorkle Ave SE",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253042501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.