Individual provider Active NPI

Donald Ray Pearson

  • Pharmacist
  • Fort Myers, FL
National Provider Identifier
1134466196
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS25973 Issued in FL
Practice address
6900 Daniels Pkwy Ste 19
Fort Myers, FL 33912-1586
Phone
(239) 768-2210
NPI assigned
Jan 10, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 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 PS25973 FL Primary

Addresses

Primary practice location

6900 Daniels Pkwy Ste 19
Fort Myers, FL 33912-1586

Mailing address

13609 Admiral CT
Fort Myers, FL 33912-5628
Phone (239) 561-5730

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

LicenseStateTypeSpecialty
PS25973FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1134466196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13609 ADMIRAL CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339125628",
            "telephone_number": "239-561-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 DANIELS PKWY STE 19",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121586",
            "telephone_number": "239-768-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "DONALD",
        "middle_name": "RAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-10",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS25973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.