Active NPI
Ivan Wolanin, PHARMD
- Pharmacist
- Winston Salem, NC
National Provider Identifier
1609184605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20801
- Practice address
- 2835 Reynolda Rd
Winston Salem, NC 27106-3110 - Phone
- (336) 723-6462
- Fax
- (336) 722-4617
- NPI assigned
- Sep 24, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20801 | NC | Primary |
Addresses
Primary practice location
2835 Reynolda Rd
Winston Salem, NC 27106-3110
Mailing address
2835 Reynolda Rd
Winston Salem, NC 27106-3110
Phone (336) 723-6462
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448582400000",
"number": "1609184605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2835 REYNOLDA RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271063110",
"telephone_number": "336-723-6462",
"fax_number": "336-722-4617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2835 REYNOLDA RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271063110",
"telephone_number": "336-723-6462",
"fax_number": "336-722-4617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLANIN",
"first_name": "IVAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-24",
"last_updated": "2015-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "20801",
"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 Nov 27, 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.