Individual provider Active NPI

Jeff E Willeford, RPH

  • Pharmacist
  • Waco, TX
National Provider Identifier
1093056699
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
37648 Issued in TX
Practice address
9100 Woodway Dr
Waco, TX 76712-3371
Phone
(254) 751-0912
Fax
(254) 751-7636
NPI assigned
Mar 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 37648 TX Primary

Addresses

Primary practice location

9100 Woodway Dr
Waco, TX 76712-3371

Mailing address

9100 Woodway Dr
Waco, TX 76712-3371
Phone (254) 751-0912

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
37648TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1093056699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 WOODWAY DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123371",
            "telephone_number": "254-751-0912",
            "fax_number": "254-751-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 WOODWAY DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123371",
            "telephone_number": "254-751-0912",
            "fax_number": "254-751-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEFORD",
        "first_name": "JEFF",
        "middle_name": "E",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "37648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.