Individual provider Active NPI

Jason Nathaniel Roe, PHARMD

  • Pharmacist
  • West Palm BCH, FL
National Provider Identifier
1003070616
Registry record updated Jul 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS40255 Issued in FL
Practice address
6901 Okeechobee Blvd
West Palm BCH, FL 33411-2511
Phone
(561) 683-6966
Fax
(561) 683-6966
NPI assigned
Jul 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS40255 FL Primary

Addresses

Primary practice location

6901 Okeechobee Blvd
West Palm BCH, FL 33411-2511

Mailing address

6901 Okeechobee Blvd
West Palm BCH, FL 33411-2511
Phone (561) 683-6966

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

LicenseStateTypeSpecialty
PS40255FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1215820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215820800000",
    "number": "1003070616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 OKEECHOBEE BLVD",
            "city": "WEST PALM BCH",
            "state": "FL",
            "postal_code": "334112511",
            "telephone_number": "561-683-6966",
            "fax_number": "561-683-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 OKEECHOBEE BLVD",
            "city": "WEST PALM BCH",
            "state": "FL",
            "postal_code": "334112511",
            "telephone_number": "561-683-6966",
            "fax_number": "561-683-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROE",
        "first_name": "JASON",
        "middle_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-12",
        "last_updated": "2008-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS40255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm BCH, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2008; 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.