NPIMap

Organization Active NPI

William Leon Ellis Jr

  • Pharmacy
  • Lenoir, NC
National Provider Identifier
1871901264
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
5920 Issued in NC
Legal business name
WILLIAM LEON ELLIS JR
Practice address
935 Blowing Rock Blvd
Lenoir, NC 28645-3785
Phone
(828) 754-2184
Fax
(828) 754-2462
NPI assigned
Jul 29, 2014
Last updated
Jul 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Authorized official

Name
Mr. William Leon Ellis Jr., PHARMACISTNPI 1194125575
Title
Pharmacy Manager
Phone
(828) 754-2184

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5920 NC Primary

Addresses

Primary practice location

935 Blowing Rock Blvd
Lenoir, NC 28645-3785

Mailing address

935 Blowing Rock Blvd
Lenoir, NC 28645-3785
Phone (828) 754-2184

Other identifiers 1

IdentifierTypeStateIssuer
0145375MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Walmart15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1871901264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 BLOWING ROCK BLVD",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286453785",
            "telephone_number": "828-754-2184",
            "fax_number": "828-754-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 BLOWING ROCK BLVD",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286453785",
            "telephone_number": "828-754-2184",
            "fax_number": "828-754-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM LEON ELLIS JR",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-29",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "828-754-2184",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NC",
            "license": "5920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0145375",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenoir, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.