Active NPI
Paula London
- Pharmacist
- Indian Trail, NC
National Provider Identifier
1205206810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19665
- Practice address
- 2101 Younts Rd
Indian Trail, NC 28079-8505 - Phone
- (704) 882-6853
- Fax
- (704) 882-7842
- NPI assigned
- Sep 25, 2015
- Last updated
- Oct 28, 2024
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19665 | NC | Primary |
Addresses
Primary practice location
2101 Younts Rd
Indian Trail, NC 28079-8505
Mailing address
2101 Younts Rd
Indian Trail, NC 28079-8505
Phone (704) 882-6853
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 |
|---|---|---|---|
| 19665 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1205206810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 YOUNTS RD",
"city": "INDIAN TRAIL",
"state": "NC",
"postal_code": "280798505",
"telephone_number": "704-882-6853",
"fax_number": "704-882-7842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 YOUNTS RD",
"city": "INDIAN TRAIL",
"state": "NC",
"postal_code": "280798505",
"telephone_number": "704-882-6853",
"fax_number": "704-882-7842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONDON",
"first_name": "PAULA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-25",
"last_updated": "2024-10-28",
"certification_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "19665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indian Trail, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.