Active NPI
Mandi Marissa Sumners
- Pharmacist
- Advance, NC
National Provider Identifier
1861018871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29614
- Practice address
- 5322 US Highway 158
Advance, NC 27006-6907 - Phone
- (336) 940-5515
- Fax
- (336) 940-4342
- NPI assigned
- Jun 25, 2020
- Last updated
- Feb 20, 2023
- Sex
- Female
- 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 | 29614 | NC | Primary |
Addresses
Primary practice location
5322 US Highway 158
Advance, NC 27006-6907
Mailing address
5322 US Highway 158
Advance, NC 27006-6907
Phone (336) 829-1651
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
| License | State | Type | Specialty |
|---|---|---|---|
| 29614 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
5322 US Highway 158
Advance, NC 27006
Phone (336) 940-5515
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": "1593043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676851200000",
"number": "1861018871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5322 US HIGHWAY 158",
"city": "ADVANCE",
"state": "NC",
"postal_code": "270066907",
"telephone_number": "336-829-1651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5322 US HIGHWAY 158",
"city": "ADVANCE",
"state": "NC",
"postal_code": "270066907",
"telephone_number": "336-940-5515",
"fax_number": "336-940-4342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMNERS",
"first_name": "MANDI",
"middle_name": "MARISSA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-25",
"last_updated": "2023-02-20",
"certification_date": "2023-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "29614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Advance, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.