Ray McClellan Massengill III

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH017264 Issued in GA

Practice address

15767 Monticello Dr
Bristol, VA 24202-4113

Phone

(276) 591-7206

NPI assigned

Dec 15, 2017

Last updated

Dec 15, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513296000000",
    "number": "1750897666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15767 MONTICELLO DR",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242024113",
            "telephone_number": "276-591-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15767 MONTICELLO DR",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242024113",
            "telephone_number": "276-591-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENGILL",
        "first_name": "RAY",
        "middle_name": "MCCLELLAN",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-15",
        "last_updated": "2017-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH017264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica L. Loveday, PA-C
• Lutheran Family Service of VA
• LW Pharmaceuticals Inc (Life Well Pharmacy)
• Lee F Lykins III, D.D.S.
• Jonathan D Mason, RCPRS
• Barry Robert Matheson, D.D.S., M.S.D.
• Briana Leigh Maxfield
• Alex L McClintic, D.O.
• Andrea Annette McClintic, D.O.
• Kayla Lynn McFaddin-Dye, PHARMD

• Pharmacist in Bristol, VA
• Providers in Bristol, VA by specialty
• Pharmacist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2017; 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.