Individual provider Active NPI

Rebecca Boone, RPH

  • Pharmacist
  • Kannapolis, NC
National Provider Identifier
1619382249
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
09516 Issued in NC
Practice address
2420 Supercenter Dr NE
Kannapolis, NC 28083-6426
Phone
(704) 792-9830
Fax
(704) 792-9840
NPI assigned
Jun 23, 2014
Last updated
Jun 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 09516 NC Primary

Addresses

Primary practice location

2420 Supercenter Dr NE
Kannapolis, NC 28083-6426

Mailing address

300 Colony Dr
Mooresville, NC 28115-2800
Phone (704) 662-0611

Other identifiers 2

IdentifierTypeStateIssuer
502445OtherNCNABP
09516OtherNCNCBOP

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
09516NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1619382249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 COLONY DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152800",
            "telephone_number": "704-662-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 SUPERCENTER DR NE",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280836426",
            "telephone_number": "704-792-9830",
            "fax_number": "704-792-9840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "REBECCA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "09516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "502445",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBOP",
            "identifier": "09516",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kannapolis, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.