Jennifer Sharell Petty, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS45692 Issued in FL

Practice address

5108 Norwood Ave
Jacksonville, FL 32208-5032

Phone

(904) 764-4491

NPI assigned

May 31, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1275264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275264000000",
    "number": "1013236009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3308 LOWELL AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322543028",
            "telephone_number": "904-838-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 NORWOOD AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322085032",
            "telephone_number": "904-764-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "JENNIFER",
        "middle_name": "SHARELL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-31",
        "last_updated": "2010-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS45692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Petrucelli, MD
• Quinton Pettaway
• Paul Pettit, MD
• Rachel Deborah Amaru Pettway
• Beverly Jean Petty, PA-C
• Regina D Petty, MSN, APRN, PMHNP
• Rolanda Denise Petty
• Kaitlyn Pettyjohn, LCSW
• Alyssa Murphy Peyton, PA-C
• Stephanie Peyton, LCSW-QS

• Pharmacist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2010; 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.