Individual provider Active NPI

Mary Banoub

  • Pharmacist
  • Durham, NC
National Provider Identifier
1821706045
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
25034 Issued in NC
Practice address
40 Duke Medicine Cir # 1K
Durham, NC 27710-4000
Phone
(919) 681-1788
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 25034 NC Primary

Addresses

Primary practice location

40 Duke Medicine Cir # 1K
Durham, NC 27710-4000

Mailing address

1507 Catch Fly LN
Durham, NC 27713-2556

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

State licenses

LicenseStateTypeSpecialty
25034NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1821706045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 CATCH FLY LN",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277132556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 DUKE MEDICINE CIR # 1K",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277104000",
            "telephone_number": "919-681-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANOUB",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "25034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.