Active NPI
Erica Renee Mabry, PHARMD
- Pharmacist
- Eden, NC
National Provider Identifier
1912660408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP458677
- Practice address
- 103 W Stadium Dr
Eden, NC 27288-3329 - Phone
- (336) 627-4854
- NPI assigned
- Oct 21, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 30894 | NC | |
| Pharmacist | 183500000X | RP458677 | PA | Primary |
Addresses
Primary practice location
103 W Stadium Dr
Eden, NC 27288-3329
Mailing address
133 Armstrong Dr
Shavertown, PA 18708-1007
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30894 | NC | MD | Pharmacist |
| RP458677 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732492800000",
"number": "1912660408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 ARMSTRONG DR",
"city": "SHAVERTOWN",
"state": "PA",
"postal_code": "187081007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 W STADIUM DR",
"city": "EDEN",
"state": "NC",
"postal_code": "272883329",
"telephone_number": "336-627-4854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MABRY",
"first_name": "ERICA",
"middle_name": "RENEE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-21",
"last_updated": "2024-11-25",
"certification_date": "2024-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "30894",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP458677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.