Active NPI
Der Thao
- Pharmacist
- Concord, NC
National Provider Identifier
1912554593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28978
- Practice address
- 1260 Union St S
Concord, NC 28025-5810 - Phone
- (704) 793-1629
- NPI assigned
- Aug 20, 2019
- Last updated
- Aug 20, 2019
- 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 | 28978 | NC | Primary |
Addresses
Primary practice location
1260 Union St S
Concord, NC 28025-5810
Mailing address
315 N Broome St
Albemarle, NC 28001-3813
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 |
|---|---|---|---|
| 28978 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566259200000",
"number": "1912554593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 N BROOME ST",
"city": "ALBEMARLE",
"state": "NC",
"postal_code": "280013813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 UNION ST S",
"city": "CONCORD",
"state": "NC",
"postal_code": "280255810",
"telephone_number": "704-793-1629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAO",
"first_name": "DER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-20",
"last_updated": "2019-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "28978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
- Maryanna C Ter Poorten, MD
- Deborah Kay Terzis, FNP
- Kelsie Nicole Teune, PA-C
- Nehal P. Thakkar, MD
- Siddarth Thakur, MD
- The 4C Company of NC, LLC (4C Integrated Health)
- The 4C Company of NC, LLC (4C Integrated Health)
- The 4C Company of NC, LLC (4C Company of NC)
- The 4C Company of NC, LLC (4C Integrated Health)
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health Primary Care and Integrative Medicine)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.