Organization Active NPI

Pike'S Pharmacy, Inc

  • Pharmacy
  • Charlotte, NC
National Provider Identifier
1811990146
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
04081 Issued in NC
Legal business name
PIKE'S PHARMACY, INC
Practice address
2133 Shamrock Dr
Charlotte, NC 28205-2132
Phone
(704) 563-2286
Fax
(704) 563-8307
NPI assigned
May 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Authorized official

Name
Jennifer Lynn KellerNPI 1144815242
Title
Pharmacist Owner
Phone
(704) 563-2286

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 04081 NC Primary

Addresses

Primary practice location

2133 Shamrock Dr
Charlotte, NC 28205-2132

Mailing address

2133 Shamrock Dr
Charlotte, NC 28205-2132
Phone (704) 563-2286

Other identifiers 1

IdentifierTypeStateIssuer
0606491MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050928000179 NC Part B Supplier - Mass Immunization (Roster Biller Only) 2769417872 Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752796800000",
    "number": "1811990146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2133 SHAMROCK DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282052132",
            "telephone_number": "704-563-2286",
            "fax_number": "704-563-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 SHAMROCK DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282052132",
            "telephone_number": "704-563-2286",
            "fax_number": "704-563-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIKE'S PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PHARMACIST OWNER",
        "authorized_official_telephone_number": "704-563-2286"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NC",
            "license": "04081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0606491",
            "state": "NC"
        }
    ],
    "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 18, 2025; 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.