Active NPI
Kelvin Andre Sloan, RPH
- Pharmacist
- Waxhaw, NC
National Provider Identifier
1245931682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11614
- Practice address
- 1409 Venetian Way Dr
Waxhaw, NC 28173-8080 - Phone
- (704) 617-3088
- NPI assigned
- Mar 13, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 43456 | SC | |
| Pharmacist | 183500000X | 11614 | NC | Primary |
Addresses
Primary practice location
1409 Venetian Way Dr
Waxhaw, NC 28173-8080
Mailing address
1409 Venetian Way Dr
Waxhaw, NC 28173-8080
Phone (704) 617-3088
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 |
|---|---|---|---|
| 11614 | NC | MD | Professional Counselor |
| 43456 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678665600000",
"number": "1245931682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1409 VENETIAN WAY DR",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281738080",
"telephone_number": "704-617-3088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 VENETIAN WAY DR",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281738080",
"telephone_number": "704-617-3088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLOAN",
"first_name": "KELVIN",
"middle_name": "ANDRE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-13",
"last_updated": "2023-03-13",
"certification_date": "2023-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "43456",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "11614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waxhaw, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.