Individual provider Active NPI

Dustin R Shepherd

  • Pharmacist
  • Wilmington, NC
National Provider Identifier
1851698955
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21405 Issued in NC
Practice address
131 Racine Dr Ste 100
Wilmington, NC 28403-8781
Phone
(910) 784-9545
NPI assigned
Feb 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21405 NC Primary

Addresses

Primary practice location

131 Racine Dr Ste 100
Wilmington, NC 28403-8781

Mailing address

6742 Cable Car LN
Wilmington, NC 28403-3629
Phone (304) 312-3630

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
21405NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298592000000",
    "number": "1851698955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6742 CABLE CAR LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033629",
            "telephone_number": "304-312-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 RACINE DR STE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038781",
            "telephone_number": "910-784-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "DUSTIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-25",
        "last_updated": "2011-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "21405",
            "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 Feb 25, 2011; 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.