Individual provider Active NPI

Jessica Victoria Gonzalez, PHARMD, CSPI

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1619318680
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
27460 Issued in NC
Practice address
601 E 5TH St Ste 140
Charlotte, NC 28202-3092
Phone
(704) 248-3712
NPI assigned
Jul 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS53914 FL
Pharmacist 183500000X 27460 NC Primary

Addresses

Primary practice location

601 E 5TH St Ste 140
Charlotte, NC 28202-3092

Mailing address

9503 Inverness Bay Rd
Charlotte, NC 28278-6726
Phone (305) 431-3664

Other practice location 1

4440 Golf Acres Drive
Atrium Health
Charlotte, NC 28208
Phone (305) 431-3664

Other identifiers 2

IdentifierTypeStateIssuer
PS53914OtherFLPHARMACIST LICENSE
27460OtherNCPHARMACIST LICENSE

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
PS53914FLMDPharmacist
27460NCMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Care Ring, Inc. CurrentSince Apr 21, 2024 Accepting new patients

Locations

601 E 5th St
Ste 140
Charlotte, NC 28202
Phone (704) 248-3711

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.

NPI Registry JSON

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1619318680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9503 INVERNESS BAY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282786726",
            "telephone_number": "305-431-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 5TH ST STE 140",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282023092",
            "telephone_number": "704-248-3712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4440 Golf Acres Drive",
            "address_2": "Atrium Health",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28208",
            "country_code": "US",
            "telephone_number": "305-431-3664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JESSICA",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "PHARMD, CSPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2023-12-01",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS53914",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "27460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PS53914",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "27460",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 1, 2023; 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.