Active NPI
Carlo Mirabelli, R.PH.
- Pharmacist
- Staunton, VA
National Provider Identifier
1962003319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202206534
- 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
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 | 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0202206534 | VA | MD | Pharmacist |
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.