Individual provider Active NPI

Cameron Burroughs

  • Pharmacist
  • Fayetteville, NC
National Provider Identifier
1457063760
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28037 Issued in NC
Practice address
7300 S Raeford Rd
Fayetteville, NC 28304-6162
Phone
(910) 488-2120
NPI assigned
Dec 19, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28037 NC Primary

Addresses

Primary practice location

7300 S Raeford Rd
Fayetteville, NC 28304-6162

Mailing address

105 Lakeside Dr
Tabor City, NC 28463-8827
Phone (910) 625-5665

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
28037NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1457063760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 LAKESIDE DR",
            "city": "TABOR CITY",
            "state": "NC",
            "postal_code": "284638827",
            "telephone_number": "910-625-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 S RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283046162",
            "telephone_number": "910-488-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "CAMERON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "28037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.