Active NPI
Traci S Powers, PHARMD
- Pharmacist
- Conway, SC
National Provider Identifier
1992173512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36263
- Practice address
- 3320 4TH Ave Ste F
Conway, SC 29527-6057 - Phone
- (843) 248-6550
- NPI assigned
- Sep 14, 2015
- 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 | 36263 | SC | Primary |
Addresses
Primary practice location
3320 4TH Ave Ste F
Conway, SC 29527-6057
Mailing address
538 S Eaddy Ford Rd
Johnsonville, SC 29555-5201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 71399D | Medicaid | SC |
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 |
|---|---|---|---|
| 36263 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southside Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514419200000",
"number": "1992173512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "538 S EADDY FORD RD",
"city": "JOHNSONVILLE",
"state": "SC",
"postal_code": "295555201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3320 4TH AVE STE F",
"city": "CONWAY",
"state": "SC",
"postal_code": "295276057",
"telephone_number": "843-248-6550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWERS",
"first_name": "TRACI",
"middle_name": "S",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-14",
"last_updated": "2017-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "36263",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "71399D",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conway, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.