Individual provider Active NPI

Gidnie Metayer, PHARMD

  • Pharmacist
  • Boynton Beach, FL
National Provider Identifier
1063125128
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS65302 Issued in FL
Practice address
12425 Hagen Ranch Rd
Boynton Beach, FL 33437-4107
Phone
(561) 292-4494
Fax
(561) 292-4499
NPI assigned
Jan 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS65302 FL Primary

Addresses

Primary practice location

12425 Hagen Ranch Rd
Boynton Beach, FL 33437-4107

Mailing address

12425 Hagen Ranch Rd
Boynton Beach, FL 33437-4107
Phone (561) 292-4494

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
PS65302FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets Inc PastSince Jan 8, 2023 Accepting new patients
Publix Super Markets Inc PastSince Jan 8, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1063125128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12425 HAGEN RANCH RD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334374107",
            "telephone_number": "561-292-4494",
            "fax_number": "561-292-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12425 HAGEN RANCH RD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334374107",
            "telephone_number": "561-292-4494",
            "fax_number": "561-292-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METAYER",
        "first_name": "GIDNIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS65302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.