Active NPI
Joe L Atwater Jr., R.PH.
- Pharmacist
- Cary, NC
National Provider Identifier
1669750832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11288
- Practice address
- 5859 Tryon Rd
Cary, NC 27518-9311 - Phone
- (919) 233-2929
- Fax
- (919) 233-4547
- NPI assigned
- Jul 21, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11288 | NC | Primary |
| Pharmacist | 183500000X | 0202206306 | VA |
Addresses
Primary practice location
5859 Tryon Rd
Cary, NC 27518-9311
Mailing address
5859 Tryon Rd
Cary, NC 27518-9311
Phone (919) 233-2929
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 |
|---|---|---|---|
| 11288 | NC | MD | Mental Health Counselor |
| 0202206306 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy L.L.C | Past | Accepting new patients | |
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311206400000",
"number": "1669750832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5859 TRYON RD",
"city": "CARY",
"state": "NC",
"postal_code": "275189311",
"telephone_number": "919-233-2929",
"fax_number": "919-233-4547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5859 TRYON RD",
"city": "CARY",
"state": "NC",
"postal_code": "275189311",
"telephone_number": "919-233-2929",
"fax_number": "919-233-4547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATWATER",
"first_name": "JOE",
"middle_name": "L",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-21",
"last_updated": "2011-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "11288",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202206306",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.