Pebblebrook Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH26789 Issued in FL

Legal business name

PEBBLEBROOK INC

Practice address

15215 Collier Blvd Ste 308
Naples, FL 34119-6835

Phone

(239) 353-0800

Fax

(239) 353-0804

NPI assigned

Apr 17, 2013

Organization subpart

No

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

Authorized official

Name

Suresh Chaudhari, RPHNPI 1790009819

Title

Authorize Person

Phone

(239) 560-4354

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• PEBBLEBROOK PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Pebblebrook Inc

  • Community/Retail Pharmacy
  • Naples, FL
  • NPI 1396263299

  O20210115000770, O20210129002070

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suresh Chaudhari

  • Pharmacist
  • Naples, FL
  • NPI 1790009819
  NPD Authorized official
• Chintankumar Thakkar

  • Pharmacist
  • Naples, FL
  • NPI 1124784350
  NPD

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1063856367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15215 COLLIER BLVD",
            "address_2": "SUIT#308",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341196834",
            "telephone_number": "239-353-0800",
            "fax_number": "239-353-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15215 COLLIER BLVD STE 308",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341196835",
            "telephone_number": "239-353-0800",
            "fax_number": "239-353-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEBBLEBROOK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-17",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "CHAUDHARI",
        "authorized_official_first_name": "SURESH",
        "authorized_official_title_or_position": "AUTHORIZE PERSON",
        "authorized_official_telephone_number": "239-560-4354",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH26789",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139949",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008590000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEBBLEBROOK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PEBBLEBROOK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christine Noelle Peacock, M.A., CCC-A
• Bethany Pearce, RMHCI
• Edward Pearce, PA-C
• Jasmine Pearce
• Carrie Elizabeth Pearson, PA-C
• Pebblebrook Inc
• Colleen Victoria Pecoraro, PT
• Pediatric Associates of SWFL PA
• Pediatric Therapy Intensives LLC
• Pediatrix Medical Group of Florida Inc

• Community/Retail Pharmacy in Naples, FL
• Providers in Naples, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.