KATIE DIRCKSEN (NPI# 1104471432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104471432 |
| Entity Type | Individual |
| Full Name | KATIE DIRCKSEN |
| Credential | PHARMD |
| Practice Address |
1638 Owen Dr Fayetteville NC 28304-3424 |
| Practice Telephone | 9106157183 |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2019-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
28922 | NC | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | PHARMACY LICENSE | 28922 | 01 |
| Street Address |
1638 OWEN DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-3424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821091851 | Cumberland County Hospital System, Inc | General Acute Care Hospital | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2005-05-23 |
| 1265032536 | Heidi Ellen Jumbercotta | Internal Medicine | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-10-27 |
| 1346848306 | Jessica Hooten | Nurse Practitioner | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-10-13 |
| 1881200665 | Kathleen Macalalag | Pharmacist | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-09-17 |
| 1790395523 | Anna Caitlyn Felmer | Pharmacist | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-08-06 |
| 1427668359 | Benjamin Josiah Tutterow | Pharmacist | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-08-05 |
| 1063022994 | George Thomas Sessoms IIi | Pharmacist | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-08-05 |
| 1437769759 | Teresa Cooper Jones | Pharmacist | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-08-01 |
| 1881202901 | Chantel Davis | Specialist/Technologist, Other | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-07-15 |
| 1194333237 | Alyssa Worley | Occupational Therapy Assistant | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518249739 | William J. Holcomb | Pharmacist | 880 Hwy 85 South, Fayetteville, GA 30215 | 2011-09-14 |
| 1669072492 | Linda Xiong | Pharmacist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-10-30 |
| 1861092082 | Teresa Wells | Pharmacist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-10-27 |
| 1801495874 | Chase Benson Bishop | Pharmacist | 805 Glynn St S, Fayetteville, GA 30214-2000 | 2020-10-21 |
| 1407454002 | Tiffany Udoka Uzor | Pharmacist | 134 Banks Xing, Fayetteville, GA 30214-7308 | 2020-10-15 |
| 1295341741 | Lindsey Christine Judy | Pharmacist | 72 Whitewater Ave, Fayetteville, WV 25840-9648 | 2020-09-21 |
| 1780218396 | Kevin Alexander Eason | Pharmacist | 134 Banks Xing, Fayetteville, GA 30214-7308 | 2020-02-24 |
| 1790317493 | Yancy Max Witt | Pharmacist | 134 Banks Xing, Fayetteville, GA 30214-7308 | 2020-02-10 |
| 1558915801 | Meghan Elizabeth Mark | Pharmacist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2019-07-25 |
| 1619490679 | Erika Rae Mcclain | Pharmacist | 1307 Avon St, Fayetteville, NC 28304-4423 | 2017-07-21 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on KATIE DIRCKSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.