Vaxclinic, LLC

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

Legal business name

VAXCLINIC, LLC

Practice address

4400 Park Rd Ste 316
Charlotte, NC 28209-3289

Phone

(606) 424-2781

NPI assigned

Sep 22, 2020

Organization subpart

Yes

Parent organization

VAXCLINIC, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Samantha Lee Howard, PHARMDNPI 1487140901

Title

Pharmacist

Phone

(704) 755-5656

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Part of

Vaxclinic LLC

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Vaxclinic, LLC

  • Pharmacist
  • Lexington, KY
  • NPI 1679131775

  Member Of

  NPD member

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samantha Lee Howard, PHARMD

  • Pharmacist
  • Belmont, NC
  • NPI 1487140901
  NPD Authorized official
• Joseph Bero, PHARMD

  • Pharmacist
  • Charlotte, NC
  • NPI 1093117798
  NPD
• Lori Welke, PA-C

  • Physician Assistant
  • Peoria, IL
  • NPI 1326237637
  NPD (past)

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1730795873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 TAMWORTH DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104109",
            "telephone_number": "606-424-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 PARK RD STE 316",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093289",
            "telephone_number": "606-424-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAXCLINIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VAXCLINIC, LLC",
        "enumeration_date": "2020-09-22",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "704-755-5656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy D Vaughn, NP
• Lori Walker Vaught, NP
• Tamara Vaught, LCASA
• Jessica H Vavoulis, PT
• Sara Trexler Vavra, LCMHCA
• Ornela Amliv Vazquez Rivera, BCBA
• Franchesca Vazquez Suarez, MSW/LCSWA
• Alicia K Vazquez, OT
• Alyna Marie Vazquez, BA
• Devyn Vazquez, BCBA

• Clinic Pharmacy in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinic Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.