Active NPI
Kaitlyn Mizelle
- Pharmacist
- Washington, NC
National Provider Identifier
1619650934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 32517
- Practice address
- 1020 John Small Ave
Washington, NC 27889-3759 - Phone
- (252) 946-9631
- NPI assigned
- Aug 11, 2023
- Last updated
- Aug 11, 2023
- Sex
- Female
- 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 | 32517 | NC | Primary |
Addresses
Primary practice location
1020 John Small Ave
Washington, NC 27889-3759
Mailing address
1020 John Small Ave
Washington, NC 27889-3759
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32517 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691712000000",
"number": "1619650934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 JOHN SMALL AVE",
"city": "WASHINGTON",
"state": "NC",
"postal_code": "278893759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 JOHN SMALL AVE",
"city": "WASHINGTON",
"state": "NC",
"postal_code": "278893759",
"telephone_number": "252-946-9631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIZELLE",
"first_name": "KAITLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-11",
"last_updated": "2023-08-11",
"certification_date": "2023-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "32517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, NC
- Metropolitan Community Health Services, Inc. (Agape Health Services - Carolina Avenue)
- Metropolitan Community Health Services, Inc. (Agape Health Services - Carolina Avenue)
- Metropolitan Homecare and Behavioral Services
- Billy R Miller
- Erika Mitchell
- Amy Michelle Modlin, DO
- Jeffrey Mohr, CST-CSFA
- Monarch
- Monarch
- Brodie Moore, EMT-B
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.