Individual provider Active NPI

Cynthia Peters Burgess, RPH

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1972053742
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
08574 Issued in NC
Practice address
8909 JW Clay Blvd
Charlotte, NC 28262-5415
Phone
(704) 593-0769
Fax
(704) 593-0710
NPI assigned
Oct 5, 2016
Last updated
Oct 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 08574 NC Primary
Pharmacist 183500000X 6211 SC

Addresses

Primary practice location

8909 JW Clay Blvd
Charlotte, NC 28262-5415

Mailing address

8909 JW Clay Blvd
Charlotte, NC 28262-5415
Phone (704) 593-0769

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
08574NCMDPharmacist
6211SCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1972053742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8909 JW CLAY BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282625415",
            "telephone_number": "704-593-0769",
            "fax_number": "704-593-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8909 JW CLAY BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282625415",
            "telephone_number": "704-593-0769",
            "fax_number": "704-593-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "CYNTHIA",
        "middle_name": "PETERS",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "08574",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "6211",
            "primary": false
        }
    ],
    "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 Oct 5, 2016; 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.