Active NPI
Charlene Mong
- Pharmacist
- Waynesville, NC
National Provider Identifier
1417189028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20169
- Practice address
- 590 Russ Ave
Waynesville, NC 28786-2936 - Phone
- (828) 452-4211
- NPI assigned
- Aug 14, 2009
- Last updated
- Aug 24, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 20169 | NC | Primary |
Addresses
Primary practice location
590 Russ Ave
Waynesville, NC 28786-2936
Mailing address
590 Russ Ave
Waynesville, NC 28786-2936
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 |
|---|---|---|---|
| 20169 | NC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251072000000",
"number": "1417189028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 RUSS AVE",
"city": "WAYNESVILLE",
"state": "NC",
"postal_code": "287862936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 RUSS AVE",
"city": "WAYNESVILLE",
"state": "NC",
"postal_code": "287862936",
"telephone_number": "828-452-4211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONG",
"first_name": "CHARLENE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-14",
"last_updated": "2009-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "20169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waynesville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.