Active NPI
Dustin Thomas Roe, PHARMD
- Pharmacist
- Statesville, NC
National Provider Identifier
1659922219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29089
- Practice address
- 430 Western Ave
Statesville, NC 28677-5730 - Phone
- (704) 873-7612
- Fax
- (704) 872-8037
- NPI assigned
- Sep 25, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | 29089 | NC | Primary |
Addresses
Primary practice location
430 Western Ave
Statesville, NC 28677-5730
Mailing address
116 Endicott CT
Mooresville, NC 28115-5225
Phone (828) 964-6918
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
| License | State | Type | Specialty |
|---|---|---|---|
| 29089 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beam & Chapman Inc | Past | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Statesville, NC
- NPI 1073535647
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684454400000",
"number": "1659922219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 ENDICOTT CT",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281155225",
"telephone_number": "828-964-6918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 WESTERN AVE",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286775730",
"telephone_number": "704-873-7612",
"fax_number": "704-872-8037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROE",
"first_name": "DUSTIN",
"middle_name": "THOMAS",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-25",
"last_updated": "2023-05-19",
"certification_date": "2023-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "29089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Statesville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.