Active NPI
Maggie Meadows Kornblum, PHARMD
- Pharmacist
- Southport, NC
National Provider Identifier
1871010553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 27100
- Practice address
- 1531 N Howe St
Southport, NC 28461-2608 - Phone
- (910) 457-4721
- NPI assigned
- Aug 24, 2017
- 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 | 27100 | NC | Primary |
Addresses
Primary practice location
1531 N Howe St
Southport, NC 28461-2608
Mailing address
433 Esthwaite Dr SE
Leland, NC 28451-3408
Phone (252) 646-2579
Other practice location 1
403 S Poplar St
Elizabethtown, NC 28337-5073
Phone (910) 247-3026
Other names 1
- Maggie Olivia Meadows
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 |
|---|---|---|---|
| 27100 | NC | MD | Addiction (Substance Use Disorder) Counselor |
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.
-
- Pharmacy
- Elizabethtown, NC
- NPI 1518364827
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620000000000",
"number": "1871010553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "433 ESTHWAITE DR SE",
"city": "LELAND",
"state": "NC",
"postal_code": "284513408",
"telephone_number": "252-646-2579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1531 N HOWE ST",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284612608",
"telephone_number": "910-457-4721"
}
],
"practiceLocations": [
{
"address_1": "403 S Poplar St",
"address_purpose": "LOCATION",
"city": "Elizabethtown",
"state": "NC",
"postal_code": "283375073",
"country_code": "US",
"telephone_number": "910-247-3026",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KORNBLUM",
"first_name": "MAGGIE",
"middle_name": "MEADOWS",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-24",
"last_updated": "2021-05-03",
"certification_date": "2021-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "27100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MAGGIE",
"last_name": "MEADOWS",
"middle_name": "OLIVIA",
"credential": "PHARMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Southport, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.