Individual provider Active NPI

Gloria Ikuomola, PHARMD

  • Pharmacist
  • Huntersville, NC
National Provider Identifier
1194423442
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
31884 Issued in NC
Practice address
11145 Bryton Town Center Dr
Huntersville, NC 28078-7215
Phone
(704) 977-2043
NPI assigned
Feb 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 31884 NC Primary

Addresses

Primary practice location

11145 Bryton Town Center Dr
Huntersville, NC 28078-7215

Mailing address

271 Perennial Dr NW
Concord, NC 28027-7265

Other names 1

  • Dr. Gloria Famoyegun Former name

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
31884NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP PastSince Aug 3, 2025 Accepting new patients
Wal-Mart Stores East LP PastSince Feb 1, 2023 Accepting new patients
Wal-Mart Stores East, LP PastSince Feb 1, 2023 Accepting new patients

Organizations & group practices 3

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": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1194423442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 PERENNIAL DR NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280277265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11145 BRYTON TOWN CENTER DR",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787215",
            "telephone_number": "704-977-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKUOMOLA",
        "first_name": "GLORIA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "31884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "FAMOYEGUN",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.