Individual provider Active NPI

Richard Jones Whitesell

  • Pharmacist
  • Winston Salem, NC
National Provider Identifier
1407676497
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
09468 Issued in NC
Practice address
3917 Westpoint Blvd Ste a
Winston Salem, NC 27103-6723
Phone
(336) 773-1013
Fax
(336) 397-0165
NPI assigned
Oct 14, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 09468 NC Primary

Addresses

Primary practice location

3917 Westpoint Blvd Ste a
Winston Salem, NC 27103-6723

Mailing address

3917 Westpoint Blvd Ste a
Winston Salem, NC 27103-6723
Phone (336) 773-1013

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

LicenseStateTypeSpecialty
09468NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medipack Pharmacy Operator LLC CurrentSince Oct 20, 2024 Accepting new patients
NH Med Operator LLC Current Accepting new patients
Medipack Pharmacy LLC PastSince Oct 20, 2024 Accepting new patients

Locations

3917 Westpoint Blvd
Ste A
Winston Salem, NC 27103
Phone (336) 773-1013

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1407676497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 WESTPOINT BLVD STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036723",
            "telephone_number": "336-773-1013",
            "fax_number": "336-397-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WESTPOINT BLVD STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036723",
            "telephone_number": "336-773-1013",
            "fax_number": "336-397-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESELL",
        "first_name": "RICHARD",
        "middle_name": "JONES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "09468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.