Active NPI
Katheryn Louise Dyer, PHARMD
- Pharmacist
- Jacksonville, NC
National Provider Identifier
1265716013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03-1-29522
- Practice address
- 3069 Richlands Hwy
Jacksonville, NC 28540-2976 - Phone
- (910) 219-0490
- Fax
- (910) 219-0496
- NPI assigned
- Sep 28, 2011
- Last updated
- Sep 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03-1-29522 | OH | Primary |
| Pharmacist | 183500000X | 21671 | NC | |
| Pharmacist | 183500000X | 63242 | CA |
Addresses
Primary practice location
3069 Richlands Hwy
Jacksonville, NC 28540-2976
Mailing address
131 Racine Dr
Ste 100
Wilmington, NC 28403-8777
Phone (910) 784-9545
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63242 | CA | MD | Mental Health Counselor |
| 21671 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, 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": "1317168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317168000000",
"number": "1265716013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 RACINE DR",
"address_2": "STE 100",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284038777",
"telephone_number": "910-784-9545",
"fax_number": "910-784-9645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3069 RICHLANDS HWY",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285402976",
"telephone_number": "910-219-0490",
"fax_number": "910-219-0496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYER",
"first_name": "KATHERYN",
"middle_name": "LOUISE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-28",
"last_updated": "2011-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03-1-29522",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "21671",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "63242",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
- Nicole Dunnigan, PMHNP-BC
- Madison Elizabeth Duran
- Shirby Durant, LCSWA, LCASA
- Amanda Elmore Durham, LPC, LCAS-A
- Molly Caitlin Durham, DC
- Nakia Dyer
- Catherine Lyndsay Dyson, DDS
- East Carolina Brace & Limb Co., Inc.
- East Carolina Gastroenterology Endoscopy Center
- East Carolina Gastroenterology Endoscopy Center Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.