Active NPI
Lauren Michelle Lee Elijah, PHARMD
- Pharmacist
- Southport, NC
National Provider Identifier
1922406230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 24448
- Practice address
- 1675 N Howe St
Southport, NC 28461-2610 - Phone
- (910) 454-9950
- NPI assigned
- Dec 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 24448 | NC | Primary |
Addresses
Primary practice location
1675 N Howe St
Southport, NC 28461-2610
Mailing address
1675 N Howe St
Southport, NC 28461-2610
Phone (910) 454-9950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0745902 | Medicaid | NC |
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 |
|---|---|---|---|
| 24448 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Community/Retail Pharmacy | Past | Accepting new patients |
| Walgreen Co | Community/Retail Pharmacy | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1922406230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1675 N HOWE ST",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284612610",
"telephone_number": "910-454-9950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1675 N HOWE ST",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284612610",
"telephone_number": "910-454-9950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIJAH",
"first_name": "LAUREN",
"middle_name": "MICHELLE LEE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-18",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "24448",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0745902",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southport, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.