Individual provider Active NPI

Callista M Henson, R.PH

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1891943544
Registry record updated Sep 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16299 Issued in NC
Practice address
2516 Central Ave
Charlotte, NC 28205-5313
Phone
(704) 344-6494
Fax
(704) 344-6469
NPI assigned
Sep 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 25452 MI
Pharmacist 183500000X 16299 NC Primary

Addresses

Primary practice location

2516 Central Ave
Charlotte, NC 28205-5313

Mailing address

PO Box 36839
Charlotte, NC 28236-6839
Phone (704) 576-4162

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
25452MIMDPharmacist
16299NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1220745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220745600000",
    "number": "1891943544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36839",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282366839",
            "telephone_number": "704-576-4162",
            "fax_number": "704-364-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 CENTRAL AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282055313",
            "telephone_number": "704-344-6494",
            "fax_number": "704-344-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "CALLISTA",
        "middle_name": "M",
        "credential": "R.PH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-07",
        "last_updated": "2008-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "25452",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "16299",
            "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 Sep 7, 2008; 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.