Active NPI
Jerry Michael Horner, PHARM.D,
- Pharmacist
- Concord, CA
National Provider Identifier
1053628842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 64405
- Practice address
- 2540 East St
Concord, CA 94520-1906 - Phone
- (925) 682-8200
- NPI assigned
- Sep 1, 2010
- 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 | 64405 | CA | Primary |
Addresses
Primary practice location
2540 East St
Concord, CA 94520-1906
Mailing address
727 Navaronne Way
Concord, CA 94518-2322
Phone (209) 484-7976
Other practice location 1
1425 S Main St
Walnut Creek, CA 94596-5318
Phone (925) 295-4000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 64405 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640131200000",
"number": "1053628842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "727 NAVARONNE WAY",
"city": "CONCORD",
"state": "CA",
"postal_code": "945182322",
"telephone_number": "209-484-7976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2540 EAST ST",
"city": "CONCORD",
"state": "CA",
"postal_code": "945201906",
"telephone_number": "925-682-8200"
}
],
"practiceLocations": [
{
"address_1": "1425 S Main St",
"address_purpose": "LOCATION",
"city": "Walnut Creek",
"state": "CA",
"postal_code": "945965318",
"country_code": "US",
"telephone_number": "925-295-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HORNER",
"first_name": "JERRY",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PHARM.D,",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-01",
"last_updated": "2021-12-22",
"certification_date": "2021-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "64405",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1425 S Main St",
"city": "Walnut Creek",
"state": "CA",
"country_code": "US",
"postal_code": "945965318",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.