Individual provider Active NPI

David Kopaczewski, PHAMD

  • Pharmacist
  • Wilmington, NC
National Provider Identifier
1215222872
Registry record updated Jun 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15448 Issued in NC
Practice address
4600 Oleander Dr
Wilmington, NC 28403-5149
Phone
(910) 392-1921
Fax
(910) 791-3435
NPI assigned
Jun 12, 2011
Last updated
Jun 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15448 NC Primary

Addresses

Primary practice location

4600 Oleander Dr
Wilmington, NC 28403-5149

Mailing address

4600 Oleander Dr
Wilmington, NC 28403-5149
Phone (910) 392-1921

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

LicenseStateTypeSpecialty
15448NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1307836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307836800000",
    "number": "1215222872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035149",
            "telephone_number": "910-392-1921",
            "fax_number": "910-791-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035149",
            "telephone_number": "910-392-1921",
            "fax_number": "910-791-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPACZEWSKI",
        "first_name": "DAVID",
        "credential": "PHAMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-12",
        "last_updated": "2011-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "15448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2011; 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.