Active NPI
Autumn Stevens
- Pharmacist
- Statesville, NC
National Provider Identifier
1295389641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28974
- Practice address
- 1716 E Broad St
Statesville, NC 28625-4306 - Phone
- (704) 872-8131
- NPI assigned
- Jul 24, 2019
- 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 | 28974 | NC | Primary |
Addresses
Primary practice location
1716 E Broad St
Statesville, NC 28625-4306
Mailing address
1009 Tennessee St
Kannapolis, NC 28083-6750
Phone (704) 928-6660
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 |
|---|---|---|---|
| 28974 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563926400000",
"number": "1295389641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 TENNESSEE ST",
"city": "KANNAPOLIS",
"state": "NC",
"postal_code": "280836750",
"telephone_number": "704-928-6660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1716 E BROAD ST",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286254306",
"telephone_number": "704-872-8131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "AUTUMN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-24",
"last_updated": "2019-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "NC",
"license": "28974",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Statesville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.