Individual provider Active NPI

Jason Amedeo Carr

  • Pharmacist
  • Madeira Beach, FL
National Provider Identifier
1033712856
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS54069 Issued in FL
Practice address
15129 Madeira Way
Madeira Beach, FL 33708-1963
Phone
(727) 397-5535
Fax
(727) 398-1049
NPI assigned
Nov 17, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS54069 FL Primary

Addresses

Primary practice location

15129 Madeira Way
Madeira Beach, FL 33708-1963

Mailing address

15129 Madeira Way
Madeira Beach, FL 33708-1963
Phone (727) 397-5535

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

State licenses

LicenseStateTypeSpecialty
PS54069FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1033712856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15129 MADEIRA WAY",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337081963",
            "telephone_number": "727-397-5535",
            "fax_number": "727-398-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15129 MADEIRA WAY",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337081963",
            "telephone_number": "727-397-5535",
            "fax_number": "727-398-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "JASON",
        "middle_name": "AMEDEO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS54069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madeira Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.