Active NPI
Olivia Santoso Bentley, PHARM.D.
- Pharmacist
- Charlotte, NC
National Provider Identifier
1558772434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 22881
- Practice address
- 7308 E Independence Blvd Ste I
Charlotte, NC 28227-9440 - Phone
- (704) 537-0909
- Fax
- (704) 537-0947
- NPI assigned
- May 14, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 22881 | NC | Primary |
| Pharmacist | 183500000X | 026916 | GA | |
| Orthotic Fitter | 225000000X | 1722 |
Addresses
Primary practice location
7308 E Independence Blvd Ste I
Charlotte, NC 28227-9440
Mailing address
7308 E Independence Blvd Ste I
Charlotte, NC 28227-9440
Phone (704) 537-0909
Other names 1
- Dr. Olivia Regina Santoso
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
| License | State | Type | Specialty |
|---|---|---|---|
| 026916 | GA | MD | Pharmacist |
| 22881 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Afya Group LLC | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Charlotte, NC
- NPI 1235375742
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450915200000",
"number": "1558772434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7308 E INDEPENDENCE BLVD STE I",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282279440",
"telephone_number": "704-537-0909",
"fax_number": "704-537-0947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7308 E INDEPENDENCE BLVD STE I",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282279440",
"telephone_number": "704-537-0909",
"fax_number": "704-537-0947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTLEY",
"first_name": "OLIVIA",
"middle_name": "SANTOSO",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-14",
"last_updated": "2015-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "22881",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "026916",
"primary": false
},
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": null,
"license": "1722",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "OLIVIA",
"last_name": "SANTOSO",
"middle_name": "REGINA",
"prefix": "DR.",
"credential": "PHARM.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.