Active NPI
Jenny Ly
- Pharmacist
- Shallotte, NC
National Provider Identifier
1932986320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 32096
- Practice address
- 4553 Main St
Shallotte, NC 28470-4447 - Phone
- (910) 754-9351
- NPI assigned
- Sep 11, 2023
- 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 | 32096 | NC | Primary |
Addresses
Primary practice location
4553 Main St
Shallotte, NC 28470-4447
Mailing address
3706 Chestnut Grove Rd
Leland, NC 28451-2567
Phone (607) 372-0072
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 |
|---|---|---|---|
| 32096 | NC | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1932986320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3706 CHESTNUT GROVE RD",
"city": "LELAND",
"state": "NC",
"postal_code": "284512567",
"telephone_number": "607-372-0072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4553 MAIN ST",
"city": "SHALLOTTE",
"state": "NC",
"postal_code": "284704447",
"telephone_number": "910-754-9351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "JENNY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-11",
"last_updated": "2023-09-11",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "32096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shallotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.