Active NPI
Thomas James Henderson, R.PH.
- Pharmacist
- Mooresville, NC
National Provider Identifier
1669729331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16080
- Practice address
- 107 Argus LN
Mooresville, NC 28117-6977 - Phone
- (704) 696-0447
- Fax
- (704) 696-0453
- NPI assigned
- Aug 12, 2012
- Sex
- Male
- 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 | 16080 | NC | Primary |
Addresses
Primary practice location
107 Argus LN
Mooresville, NC 28117-6977
Mailing address
107 Argus LN
Mooresville, NC 28117-6977
Phone (704) 696-0447
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16080 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344729600000",
"number": "1669729331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 ARGUS LN",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281176977",
"telephone_number": "704-696-0447",
"fax_number": "704-696-0453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 ARGUS LN",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281176977",
"telephone_number": "704-696-0447",
"fax_number": "704-696-0453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "THOMAS",
"middle_name": "JAMES",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-12",
"last_updated": "2012-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "16080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mooresville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.