Active NPI
Jerry Lynn Philmon, R.PH.
- Pharmacist
- Beaumont, TX
National Provider Identifier
1013569292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16412
- Practice address
- 3955 Phelan Blvd
Beaumont, TX 77707-2223 - Phone
- (409) 833-1298
- Fax
- (409) 833-1667
- NPI assigned
- Jul 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | 16412 | TX | Primary |
Addresses
Primary practice location
3955 Phelan Blvd
Beaumont, TX 77707-2223
Mailing address
3955 Phelan Blvd
Beaumont, TX 77707-2223
Phone (409) 833-1298
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16412 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Retail Investors of Texas, LTD. | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Beaumont, TX
- NPI 1609937770
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562630400000",
"number": "1013569292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3955 PHELAN BLVD",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777072223",
"telephone_number": "409-833-1298",
"fax_number": "409-833-1667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3955 PHELAN BLVD",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777072223",
"telephone_number": "409-833-1298",
"fax_number": "409-833-1667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILMON",
"first_name": "JERRY",
"middle_name": "LYNN",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-09",
"last_updated": "2019-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "16412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.