Active NPI
Sireatta Gibson Atwater, R.PH.
- Pharmacist
- Durham, NC
National Provider Identifier
1710296678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11339
- Practice address
- 3737 N. Roxboro Rd.
Durham, NC 27705 - Phone
- (919) 471-4166
- Fax
- (919) 620-7926
- NPI assigned
- Sep 27, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11339 | NC | Primary |
| Pharmacist | 183500000X | 0202205196 | VA |
Addresses
Primary practice location
3737 N. Roxboro Rd.
Durham, NC 27705
Mailing address
3737 N. Roxboro Rd.
Durham, NC 27705
Phone (919) 471-4166
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 |
|---|---|---|---|
| 11339 | NC | MD | Pharmacist |
| 0202205196 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285545600000",
"number": "1710296678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3737 N. ROXBORO RD.",
"city": "DURHAM",
"state": "NC",
"postal_code": "27705",
"telephone_number": "919-471-4166",
"fax_number": "919-620-7926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3737 N. ROXBORO RD.",
"city": "DURHAM",
"state": "NC",
"postal_code": "27705",
"telephone_number": "919-471-4166",
"fax_number": "919-620-7926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATWATER",
"first_name": "SIREATTA",
"middle_name": "GIBSON",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-27",
"last_updated": "2010-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "11339",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202205196",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.