Individual provider Active NPI

Tracey Rabon, PHARMD

  • Pharmacist
  • Hartsville, SC
National Provider Identifier
1376919134
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10721 Issued in SC
Practice address
1150 S Forth Street
Hartsville, SC 29550
Phone
(843) 332-8111
NPI assigned
Aug 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10721 SC Primary

Addresses

Primary practice location

1150 S Forth Street
Hartsville, SC 29550

Mailing address

1150 S Forth Street
Hartsville, SC 29550
Phone (843) 332-8111

Other identifiers 1

IdentifierTypeStateIssuer
10721OtherSCPHARMACIST LICENSE

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1376919134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 S FORTH STREET",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "29550",
            "telephone_number": "843-332-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 S FORTH STREET",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "29550",
            "telephone_number": "843-332-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABON",
        "first_name": "TRACEY",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "10721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "10721",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; 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.