Individual provider Active NPI

Metkel Tecle

  • Pharmacist
  • Waxhaw, NC
National Provider Identifier
1659199719
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
33416 Issued in NC
Practice address
10012 Weiss Way
Waxhaw, NC 28173-0800
Phone
(704) 321-2694
NPI assigned
Sep 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 33416 NC Primary

Addresses

Primary practice location

10012 Weiss Way
Waxhaw, NC 28173-0800

Mailing address

306 E Woodlawn Rd
Charlotte, NC 28217-2349
Phone (704) 525-7291

Other practice location 1

306 E Woodlawn Rd
Charlotte, NC 28217-2349
Phone (704) 525-7291

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

LicenseStateTypeSpecialty
33416NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1659199719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E WOODLAWN RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282172349",
            "telephone_number": "704-525-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 WEISS WAY",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281730800",
            "telephone_number": "704-321-2694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 E Woodlawn Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282172349",
            "country_code": "US",
            "telephone_number": "704-525-7291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TECLE",
        "first_name": "METKEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "33416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.