Active NPI
Charles Max Lesslie
- Pharmacist
- Pooler, GA
National Provider Identifier
1548864630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH029159
- Practice address
- 500 Pooler Pkwy
Pooler, GA 31322-5171 - Phone
- (912) 748-5170
- NPI assigned
- Nov 30, 2020
- Last updated
- Nov 30, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36588 | SC | |
| Pharmacist | 183500000X | RPH029159 | GA | Primary |
Addresses
Primary practice location
500 Pooler Pkwy
Pooler, GA 31322-5171
Mailing address
500 Pooler Pkwy
Pooler, GA 31322-5171
Phone (912) 748-5170
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 |
|---|---|---|---|
| RPH029159 | GA | MD | Pharmacist |
| 36588 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia CVS Pharmacy L.L.C | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1548864630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 POOLER PKWY",
"city": "POOLER",
"state": "GA",
"postal_code": "313225171",
"telephone_number": "912-748-5170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 POOLER PKWY",
"city": "POOLER",
"state": "GA",
"postal_code": "313225171",
"telephone_number": "912-748-5170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LESSLIE",
"first_name": "CHARLES",
"middle_name": "MAX",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "36588",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH029159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pooler, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.