Active NPI
Brittany Shoma Bly
- Pharmacist
- Boynton Beach, FL
National Provider Identifier
1073117792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS58499
- Practice address
- 9824 S Military TRL
Boynton Beach, FL 33436-3201 - Phone
- (561) 732-9115
- NPI assigned
- Nov 23, 2020
- Last updated
- Nov 23, 2020
- Sex
- Female
- 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 | PS58499 | FL | Primary |
Addresses
Primary practice location
9824 S Military TRL
Boynton Beach, FL 33436-3201
Mailing address
3063 El Camino Real
West Palm Beach, FL 33409-7832
Phone (561) 324-7956
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS58499 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS L.L.C. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606089600000",
"number": "1073117792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3063 EL CAMINO REAL",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334097832",
"telephone_number": "561-324-7956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9824 S MILITARY TRL",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "334363201",
"telephone_number": "561-732-9115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLY",
"first_name": "BRITTANY",
"middle_name": "SHOMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-23",
"last_updated": "2020-11-23",
"certification_date": "2020-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS58499",
"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 23, 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.