Individual provider Active NPI

Katelyn Hartman

  • Pharmacist
  • Winston Salem, NC
National Provider Identifier
1548873474
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
29934 Issued in NC
Practice address
1040 Hanes Mall Blvd
Winston Salem, NC 27103-1309
Phone
(336) 774-9623
NPI assigned
Aug 29, 2020
Last updated
Jul 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 29934 NC Primary

Addresses

Primary practice location

1040 Hanes Mall Blvd
Winston Salem, NC 27103-1309

Mailing address

1040 Hanes Mall Blvd
Winston Salem, NC 27103-1309
Phone (336) 774-9623

Other practice location 1

2770 Lewisville Clemmons Rd
Clemmons, NC 27012-8716
Phone (336) 766-0324

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
29934NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1548873474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 HANES MALL BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031309",
            "telephone_number": "336-774-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 HANES MALL BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031309",
            "telephone_number": "336-774-9623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2770 Lewisville Clemmons Rd",
            "address_purpose": "LOCATION",
            "city": "Clemmons",
            "state": "NC",
            "postal_code": "270128716",
            "country_code": "US",
            "telephone_number": "336-766-0324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "KATELYN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-29",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "29934",
            "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 Jul 22, 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.