Active NPI
Katie Lynn Andricopulos, PHARMD
- Pediatric Pharmacist
- Charlotte, NC
National Provider Identifier
1760827729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pharmacist
- License
- 24607
- Practice address
- 301 Hawthorne LN Ste 100
Charlotte, NC 28204 - Phone
- (704) 384-1900
- Fax
- (704) 384-1919
- NPI assigned
- May 5, 2013
- Reactivated
- Jul 10, 2018
- Last updated
- Jul 11, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Pharmacist | 1835P0200X | 24607 | NC | Primary |
Addresses
Primary practice location
301 Hawthorne LN Ste 100
Charlotte, NC 28204
Mailing address
800 Rose St
Lexington, KY 40536-0293
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
| License | State | Type | Specialty |
|---|---|---|---|
| 24607 | NC | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531267200000",
"number": "1760827729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 ROSE ST",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405360293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 HAWTHORNE LN STE 100",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28204",
"telephone_number": "704-384-1900",
"fax_number": "704-384-1919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRICOPULOS",
"first_name": "KATIE",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-05",
"last_updated": "2018-07-11",
"deactivation_date": "2018-06-25",
"reactivation_date": "2018-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pediatrics",
"state": "NC",
"license": "24607",
"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 Jul 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.