Active NPI
Jaclyn Marie Perrotta, PHARM.D
- Pharmacist
- Charlotte, NC
National Provider Identifier
1699117812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 23611
- Practice address
- 11430 N Tryon St
Charlotte, NC 28262-0405 - Phone
- (704) 717-3276
- NPI assigned
- Jul 30, 2013
- Last updated
- Jul 30, 2013
- Sex
- Female
- 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 | 23611 | NC | Primary |
Addresses
Primary practice location
11430 N Tryon St
Charlotte, NC 28262-0405
Mailing address
3212 Eastover Ridge Dr
Unit 714
Charlotte, NC 28211-1466
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 |
|---|---|---|---|
| 23611 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375142400000",
"number": "1699117812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3212 EASTOVER RIDGE DR",
"address_2": "UNIT 714",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11430 N TRYON ST",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282620405",
"telephone_number": "704-717-3276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERROTTA",
"first_name": "JACLYN",
"middle_name": "MARIE",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-30",
"last_updated": "2013-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "23611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
- Michelle Marie Perno, PA
- Darci Pernoud, OT
- James A Perri, MD
- John Fitzgerald Perrin, M.D.
- Anthony M Perrino, DDS
- Perry & Barron Orthopedics & Sports Medicine PA
- Perry & Barron Orthopedics & Sports Medicine, PA
- Perry & Barron Orthopedics & Sports Medicine, PA
- Perry Counseling Healing and Recovery PLLC
- Perry T Sowell Jr DDS PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.