Individual provider Active NPI

Lillian Avery Salcedo, PHARMD

  • Student in an Organized Health Care Education/Training Program
  • Charlottesville, VA
National Provider Identifier
1437979184
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0202222351 Issued in VA
Practice address
1215 Lee St
Charlottesville, VA 22908-3404
Phone
(434) 924-2390
Fax
(434) 982-4197
NPI assigned
Oct 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 0202222351 VA
Student in an Organized Health Care Education/Training Program 390200000X 0202222351 VA Primary

Addresses

Primary practice location

1215 Lee St
Charlottesville, VA 22908-3404

Mailing address

4375 Brambleton Ave
Roanoke, VA 24018-3404
Phone (540) 776-8820

Other practice location 1

4375 Brambleton Ave
Roanoke, VA 24018-3404
Phone (540) 776-8820

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
0202222351VAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1437979184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183404",
            "telephone_number": "540-776-8820",
            "fax_number": "540-767-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229083404",
            "telephone_number": "434-924-2390",
            "fax_number": "434-982-4197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4375 Brambleton Ave",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240183404",
            "country_code": "US",
            "telephone_number": "540-776-8820",
            "fax_number": "540-767-6501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALCEDO",
        "first_name": "LILLIAN AVERY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "VA",
            "license": "0202222351",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0202222351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.