Active NPI
Lisa B Ezzell-Weeks
- Pharmacist
- Mount Olive, NC
National Provider Identifier
1265859847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13469
- Practice address
- 308 NC 55 West
Mount Olive, NC 28365 - Phone
- (919) 658-2608
- Fax
- (919) 658-2807
- NPI assigned
- Mar 21, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13469 | NC | Primary |
Addresses
Primary practice location
308 NC 55 West
Mount Olive, NC 28365
Mailing address
308 NC 55 West
Mount Olive, NC 28365
Phone (919) 658-2608
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0965741 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13469 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Past | Accepting new patients | |
| Wal-Mart Stores East, LP | 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.
-
dba Wal-Mart Pharmacy 10-3701
- Community/Retail Pharmacy
- Mount Olive, NC
- NPI 1215154208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395360000000",
"number": "1265859847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 NC 55 WEST",
"city": "MOUNT OLIVE",
"state": "NC",
"postal_code": "28365",
"telephone_number": "919-658-2608",
"fax_number": "919-658-2807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 NC 55 WEST",
"city": "MOUNT OLIVE",
"state": "NC",
"postal_code": "28365",
"telephone_number": "919-658-2608",
"fax_number": "919-658-2807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZZELL-WEEKS",
"first_name": "LISA",
"middle_name": "B",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-21",
"last_updated": "2014-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "13469",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0965741",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Olive, NC
- Dr Joann Todd & Associates of Optometry, PLLC
- Thomas Scott Draughon, M.D.
- Dva Renal Healthcare Inc (Mt Olive Dialysis)
- Edc Drug Stores Inc (Rite Aid Pharmacy 11514)
- Sara Escobar, ATC
- Stephen Douglas Fairchild, PA-C
- Family First Support Center Inc
- Family First Support Center Inc
- Family First Support Center Inc
- Family First Support Center Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.