Individual provider Active NPI

Dustin Cole Williamson, PHARM.D.

  • Pharmacist
  • Goldsboro, NC
National Provider Identifier
1265983092
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
25211 Issued in NC
Practice address
4350 US Highway 70 E
Goldsboro, NC 27534-9246
Phone
(919) 988-6040
Fax
(919) 988-6041
NPI assigned
Oct 17, 2016
Last updated
Sep 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 25211 NC Primary

Addresses

Primary practice location

4350 US Highway 70 E
Goldsboro, NC 27534-9246

Mailing address

323 W Park St
Cary, NC 27511-3229
Phone (843) 319-9612

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

LicenseStateTypeSpecialty
25211NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP Past Accepting new patients
Wal-Mart Stores East LP PastSince Sep 29, 2019 Accepting new patients
Wal-Mart Stores East, LP PastSince Sep 29, 2019 Accepting new patients

Organizations & group practices 3

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1265983092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 W PARK ST",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275113229",
            "telephone_number": "843-319-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 US HIGHWAY 70 E",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349246",
            "telephone_number": "919-988-6040",
            "fax_number": "919-988-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "DUSTIN",
        "middle_name": "COLE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-17",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "25211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.