Individual provider Active NPI

Rebecca Carle Boustani, PHARMD

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1700955507
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18283 Issued in NC
Practice address
1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228
Phone
(704) 350-1086
Fax
(704) 350-1283
NPI assigned
Nov 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18283 NC Primary

Addresses

Primary practice location

1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228

Mailing address

2155 Preakness CT
Charlotte, NC 28273-7702
Phone (704) 504-2387

Other names 1

  • Rebecca Lynn Boustani Former name

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

LicenseStateTypeSpecialty
18283NCMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700955507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 PREAKNESS CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282737702",
            "telephone_number": "704-504-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 ROZZELLES FERRY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282084228",
            "telephone_number": "704-350-1086",
            "fax_number": "704-350-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSTANI",
        "first_name": "REBECCA",
        "middle_name": "CARLE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "18283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BOUSTANI",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, 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.

Verify at the official NPI Registry.