Active NPI
Colin Edward Simonelli, PHARMD
- Pharmacist
- Wilmington, NC
National Provider Identifier
1821511304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 27123
- Practice address
- 1705 Gardner Dr
Wilmington, NC 28405-8873 - Phone
- (910) 343-5300
- NPI assigned
- Jul 17, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 27123 | NC | Primary |
Addresses
Primary practice location
1705 Gardner Dr
Wilmington, NC 28405-8873
Mailing address
1705 Gardner Dr
Wilmington, NC 28405-8873
Phone (910) 343-5300
Other practice location 1
1600 Gum Branch Rd
Jacksonville, NC 28540-5201
Phone (910) 478-4949
Other practice location 2
5717 S Nc 41 Hwy
Wallace, NC 28466
Phone (910) 285-6481
Other practice location 3
5717 S Nc 41 Hwy
Wallace, NC 28466
Phone (910) 285-6481
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 |
|---|---|---|---|
| 27123 | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702512000000",
"number": "1821511304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 GARDNER DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284058873",
"telephone_number": "910-343-5300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 GARDNER DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284058873",
"telephone_number": "910-343-5300"
}
],
"practiceLocations": [
{
"address_1": "1600 Gum Branch Rd",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "NC",
"postal_code": "285405201",
"country_code": "US",
"telephone_number": "910-478-4949",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5717 S Nc 41 Hwy",
"address_purpose": "LOCATION",
"city": "Wallace",
"state": "NC",
"postal_code": "28466",
"country_code": "US",
"telephone_number": "910-285-6481",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5717 S Nc 41 Hwy",
"address_purpose": "LOCATION",
"city": "Wallace",
"state": "NC",
"postal_code": "28466",
"country_code": "US",
"telephone_number": "910-285-6481",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMONELLI",
"first_name": "COLIN",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-17",
"last_updated": "2023-12-14",
"certification_date": "2023-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "27123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.