Individual provider Active NPI

John Grattan Clavin, RPH

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1922185693
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
09661 Issued in NC
Practice address
9201 University City Blvd
Charlotte, NC 28223-0001
Phone
(704) 687-4627
Fax
(704) 687-6715
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 09661 NC Primary

Addresses

Primary practice location

9201 University City Blvd
Charlotte, NC 28223-0001

Mailing address

2307 Sweet Bay LN
Matthews, NC 28105-6651
Phone (704) 687-2812

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
09661NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922185693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 SWEET BAY LN",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281056651",
            "telephone_number": "704-687-2812",
            "fax_number": "704-687-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 UNIVERSITY CITY BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282230001",
            "telephone_number": "704-687-4627",
            "fax_number": "704-687-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAVIN",
        "first_name": "JOHN",
        "middle_name": "GRATTAN",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "09661",
            "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 Jul 8, 2007; 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.