Individual provider Active NPI

Dustin Shaun Herrell, PHARMD

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1881980548
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19023 Issued in NC
Practice address
900 Metropolitan Ave
Charlotte, NC 28204-3177
Phone
(704) 973-3122
Fax
(704) 973-3132
NPI assigned
Jun 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 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 19023 NC Primary

Addresses

Primary practice location

900 Metropolitan Ave
Charlotte, NC 28204-3177

Mailing address

900 Metropolitan Ave
Charlotte, NC 28204-3177
Phone (704) 973-3122

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

LicenseStateTypeSpecialty
19023NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1881980548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 METROPOLITAN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043177",
            "telephone_number": "704-973-3122",
            "fax_number": "704-973-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 METROPOLITAN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043177",
            "telephone_number": "704-973-3122",
            "fax_number": "704-973-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRELL",
        "first_name": "DUSTIN",
        "middle_name": "SHAUN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "19023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.