Active NPI
Raleigh Jackson Putnam Jr., REG PHARMACIST
- Pharmacist
- Ocean Isle Beach, NC
National Provider Identifier
1912129594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 08686
- Practice address
- 7051 Bloomsbury CT SW
Ocean Isle Beach, NC 28469-3653 - Phone
- (910) 575-4335
- NPI assigned
- May 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 08686 | NC | Primary |
| Pharmacist | 183500000X | PS13583 | FL |
Addresses
Primary practice location
7051 Bloomsbury CT SW
Ocean Isle Beach, NC 28469-3653
Mailing address
7051 Bloomsbury CT SW
Ocean Isle Beach, NC 28469-3653
Phone (910) 575-4335
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 |
|---|---|---|---|
| PS13583 | FL | MD | Pharmacist |
| 08686 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374537600000",
"number": "1912129594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7051 BLOOMSBURY CT SW",
"city": "OCEAN ISLE BEACH",
"state": "NC",
"postal_code": "284693653",
"telephone_number": "910-575-4335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7051 BLOOMSBURY CT SW",
"city": "OCEAN ISLE BEACH",
"state": "NC",
"postal_code": "284693653",
"telephone_number": "910-575-4335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTNAM",
"first_name": "RALEIGH",
"middle_name": "JACKSON",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "REG PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2013-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "08686",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS13583",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ocean Isle Beach, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.