Individual provider Active NPI

Charlotte Ann Matheny, RPH

  • Pharmacist
  • Winston Salem, NC
National Provider Identifier
1639757800
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
08762 Issued in NC
Practice address
2560 Landmark Dr
Winston Salem, NC 27103-6716
Phone
(336) 760-3446
Fax
(888) 305-1267
NPI assigned
Mar 30, 2021
Last updated
Mar 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 08762 NC Primary

Addresses

Primary practice location

2560 Landmark Dr
Winston Salem, NC 27103-6716

Mailing address

2560 Landmark Dr
Winston Salem, NC 27103-6716
Phone (336) 760-3446

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
08762NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ja McNeill & Sons & Daughter II LLC CurrentSince Apr 6, 2021 Accepting new patients
Holladay Healthcare, Inc. PastSince Apr 6, 2021 Accepting new patients

Locations

2560 Landmark Dr
Winston Salem, NC 27103
Phone (336) 760-3446

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1639757800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 LANDMARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036716",
            "telephone_number": "336-760-3446",
            "fax_number": "888-305-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 LANDMARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036716",
            "telephone_number": "336-760-3446",
            "fax_number": "888-305-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHENY",
        "first_name": "CHARLOTTE",
        "middle_name": "ANN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "08762",
            "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 Mar 30, 2021; 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.