Individual provider Active NPI

David Allen Woodworth, R.PH.

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1093985053
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS33297 Issued in FL
Practice address
2160 Park St
Jacksonville, FL 32204-3812
Phone
(904) 389-9744
Fax
(904) 389-9406
NPI assigned
Mar 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS33297 FL Primary
Pharmacist 183500000X PH00009504 WA

Addresses

Primary practice location

2160 Park St
Jacksonville, FL 32204-3812

Mailing address

2160 Park St
Jacksonville, FL 32204-3812
Phone (904) 389-9744

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
PS33297FLMDPharmacist
PH00009504WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
AIDS Healthcare Foundation 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1093985053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043812",
            "telephone_number": "904-389-9744",
            "fax_number": "904-389-9406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043812",
            "telephone_number": "904-389-9744",
            "fax_number": "904-389-9406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWORTH",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS33297",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00009504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.