Individual provider Active NPI

Robert Dale Harrison, BSPHARM

  • Pharmacist
  • Kernersville, NC
National Provider Identifier
1245686591
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11764 Issued in NC
Practice address
1601 Old Greensboro Rd
Ste B
Kernersville, NC 27284-6855
Phone
(844) 871-4773
Fax
(844) 871-4776
NPI assigned
May 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11764 NC Primary
Pharmacist 183500000X 18417 AL
Pharmacist 183500000X S021155 AZ
Pharmacist 183500000X PD13115 AR
Pharmacist 183500000X PS 38395 FL
Pharmacist 183500000X PH 3848 HI
Pharmacist 183500000X P7238 ID
Pharmacist 183500000X 17505 KY
Pharmacist 183500000X PST.020979 LA
Pharmacist 183500000X 23042 MD
Pharmacist 183500000X P13841 MS
Pharmacist 183500000X 14811 NE
Pharmacist 183500000X R2575 NH
Pharmacist 183500000X RPH-0014572 OR
Pharmacist 183500000X 000038924 TN

Addresses

Primary practice location

1601 Old Greensboro Rd
Ste B
Kernersville, NC 27284-6855

Mailing address

1601 Old Greensboro Rd
Ste B
Kernersville, NC 27284-6855
Phone (844) 871-4773

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
18417ALMDPharmacist
PD13115ARMDPharmacist
S021155AZMDPharmacist
PS 38395FLMDPharmacist
PH 3848HIMDPharmacist
P7238IDMDPharmacist
17505KYMDPharmacist
PST.020979LAMDPharmacist
23042MDMDPharmacist
P13841MSMDPharmacist
11764NCMDPharmacist
14811NEMDPharmacist
R2575NHMDPharmacist
RPH-0014572ORMDPharmacist
000038924TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Nufactor, Inc. Past Accepting new patients
Nufactor Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1245686591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 OLD GREENSBORO RD",
            "address_2": "STE B",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272846855",
            "telephone_number": "844-871-4773",
            "fax_number": "844-871-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 OLD GREENSBORO RD",
            "address_2": "STE B",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272846855",
            "telephone_number": "844-871-4773",
            "fax_number": "844-871-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "ROBERT",
        "middle_name": "DALE",
        "credential": "BSPHARM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-05",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "11764",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "18417",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S021155",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD13115",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS 38395",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "PH 3848",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P7238",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "17505",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.020979",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "23042",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "P13841",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "14811",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NH",
            "license": "R2575",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0014572",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "000038924",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

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

Verify at the official NPI Registry.