Active NPI
Jeffrey Dale Shatterly, RPH
- Pharmacist
- Fayetteville, NC
National Provider Identifier
1235447590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 08927
- Practice address
- 600 Cedar Creek Rd
Fayetteville, NC 28312-6504 - Phone
- (910) 483-8972
- Fax
- (910) 484-0607
- NPI assigned
- Sep 21, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | 08927 | NC | Primary |
Addresses
Primary practice location
600 Cedar Creek Rd
Fayetteville, NC 28312-6504
Mailing address
600 Cedar Creek Rd
Fayetteville, NC 28312-6504
Phone (910) 483-8972
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
| License | State | Type | Specialty |
|---|---|---|---|
| 08927 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carlie C'S of Cedar Creek | Past | Accepting new patients | |
| Carlie C'S of Cedar Creek, LLC | Past | 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.
-
- Community/Retail Pharmacy
- Fayetteville, NC
- NPI 1245263052
-
- Community/Retail Pharmacy
- Fayetteville, NC
- NPI 1538568753
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481846400000",
"number": "1235447590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 CEDAR CREEK RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283126504",
"telephone_number": "910-483-8972",
"fax_number": "910-484-0607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 CEDAR CREEK RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283126504",
"telephone_number": "910-483-8972",
"fax_number": "910-484-0607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHATTERLY",
"first_name": "JEFFREY",
"middle_name": "DALE",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-21",
"last_updated": "2016-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "08927",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.