Active NPI
Edwin Clifton Keeter Jr., PHARM D
- Pharmacist
- Fayetteville, NC
National Provider Identifier
1780911453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19692
- Practice address
- 110 Grove St
Fayetteville, NC 28301 - Phone
- (910) 223-0270
- NPI assigned
- Nov 17, 2009
- Last updated
- Nov 17, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19692 | NC | Primary |
Addresses
Primary practice location
110 Grove St
Fayetteville, NC 28301
Mailing address
102 N Fayetteville St
PO Box 6
Lumber Bridge, NC 28357-0006
Phone (910) 843-5318
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 |
|---|---|---|---|
| 19692 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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": "1258416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258416000000",
"number": "1780911453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 N FAYETTEVILLE ST",
"address_2": "PO BOX 6",
"city": "LUMBER BRIDGE",
"state": "NC",
"postal_code": "283570006",
"telephone_number": "910-843-5318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 GROVE ST",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "28301",
"telephone_number": "910-223-0270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEETER",
"first_name": "EDWIN",
"middle_name": "CLIFTON",
"name_suffix": "Jr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-17",
"last_updated": "2009-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "19692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.