Individual provider Active NPI

Crystal Mitchell White, PHARMD

  • Pharmacist
  • Wake Forest, NC
National Provider Identifier
1578852554
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17725 Issued in NC
Practice address
12225 Capital Blvd
Wake Forest, NC 27587-6200
Phone
(919) 556-2905
Fax
(919) 556-1469
NPI assigned
Mar 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17725 NC Primary

Addresses

Primary practice location

12225 Capital Blvd
Wake Forest, NC 27587-6200

Mailing address

12225 Capital Blvd
Wake Forest, NC 27587-6200
Phone (919) 556-2905

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
17725NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1578852554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12225 CAPITAL BLVD",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876200",
            "telephone_number": "919-556-2905",
            "fax_number": "919-556-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12225 CAPITAL BLVD",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876200",
            "telephone_number": "919-556-2905",
            "fax_number": "919-556-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CRYSTAL",
        "middle_name": "MITCHELL",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "17725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; 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.