Individual provider Active NPI

Carlo Mirabelli, R.PH.

  • Pharmacist
  • Staunton, VA
National Provider Identifier
1962003319
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202206534 Issued in VA
Practice address
Wal-Mart
1028C Richmond Ave.
Staunton, VA 24401
Phone
(540) 886-4208
Fax
(540) 886-6205
NPI assigned
Nov 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 0202206534 VA Primary

Addresses

Primary practice location

Wal-Mart
1028C Richmond Ave.
Staunton, VA 24401

Mailing address

3606 Moffat St
Charlottesville, VA 22902-6250
Phone (143) 453-1054

Other practice location 1

3606 Moffat St
Charlottesville, VA 22902-6250
Phone (143) 453-1054

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 540-886-4206 Direct

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
0202206534VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1962003319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3606 MOFFAT ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229026250",
            "telephone_number": "143-453-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WAL-MART",
            "address_2": "1028C RICHMOND AVE.",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "24401",
            "telephone_number": "540-886-4208",
            "fax_number": "540-886-6205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3606 Moffat St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229026250",
            "country_code": "US",
            "telephone_number": "143-453-1054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRABELLI",
        "first_name": "CARLO",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-03",
        "last_updated": "2022-05-19",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202206534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "540-886-4206",
            "affiliation": "N",
            "endpointDescription": "Work Secure Fax",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Secure Fax",
            "address_1": "Wal-Mart",
            "address_2": "1028C Richmond Ave.",
            "city": "Staunton",
            "state": "VA",
            "country_code": "US",
            "postal_code": "24401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Staunton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.