Individual provider Active NPI

Jeffrey Lee Lemelin

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1710315585
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10720 Issued in NC
Practice address
4908 Houston Field CT
Charlotte, NC 28277-4803
Phone
(704) 814-0212
NPI assigned
Oct 14, 2013
Last updated
Sep 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10720 NC Primary

Addresses

Primary practice location

4908 Houston Field CT
Charlotte, NC 28277-4803

Mailing address

4908 Houston Field CT
Charlotte, NC 28277-4803
Phone (704) 814-0212

Other practice location 1

4390 Colwick Rd
Charlotte, NC 28211-2310
Phone (704) 364-3444

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

State licenses

LicenseStateTypeSpecialty
10720NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina CVS Pharmacy LLC PastSince Oct 1, 2023 Accepting new patients
North Carolina CVS Pharmacy, L.L.C. PastSince Oct 1, 2023 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, 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": "1381708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1710315585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 HOUSTON FIELD CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774803",
            "telephone_number": "704-814-0212",
            "fax_number": "704-364-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4908 HOUSTON FIELD CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774803",
            "telephone_number": "704-814-0212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4390 Colwick Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282112310",
            "country_code": "US",
            "telephone_number": "704-364-3444",
            "fax_number": "704-364-1320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEMELIN",
        "first_name": "JEFFREY",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-14",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "10720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 28, 2023; 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.