Active NPI
Corey R Elden Jr., PHARMD
- Pharmacist
- Concord, NC
National Provider Identifier
1689776353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14677
- Practice address
- 920 Church St N
Concord, NC 28025-2927 - Phone
- (704) 783-2079
- Fax
- (704) 783-1784
- NPI assigned
- Sep 2, 2006
- 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 | 14677 | NC | Primary |
Addresses
Primary practice location
920 Church St N
Concord, NC 28025-2927
Mailing address
329 Sycamore Ridge Rd NE
Concord, NC 28025-7806
Phone (704) 795-6470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14677 | Other | NC | PHARMACY LICENSE NUMBER |
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 |
|---|---|---|---|
| 14677 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689776353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "329 SYCAMORE RIDGE RD NE",
"city": "CONCORD",
"state": "NC",
"postal_code": "280257806",
"telephone_number": "704-795-6470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 CHURCH ST N",
"city": "CONCORD",
"state": "NC",
"postal_code": "280252927",
"telephone_number": "704-783-2079",
"fax_number": "704-783-1784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDEN",
"first_name": "COREY",
"middle_name": "R",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "14677",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE NUMBER",
"identifier": "14677",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.