Active NPI
Mark Edward Wadsworth
- Pharmacy Technician
- Englewood, FL
National Provider Identifier
1164104113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- RPT65160
- Practice address
- 15 S Indiana Ave
Englewood, FL 34223-3305 - Phone
- (941) 473-7787
- NPI assigned
- Aug 1, 2023
- Last updated
- Aug 1, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | RPT65160 | FL | Primary |
Addresses
Primary practice location
15 S Indiana Ave
Englewood, FL 34223-3305
Mailing address
1048 Kansas Ave
Englewood, FL 34223-2527
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 |
|---|---|---|---|
| RPT65160 | FL | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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": "1690848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690848000000",
"number": "1164104113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1048 KANSAS AVE",
"city": "ENGLEWOOD",
"state": "FL",
"postal_code": "342232527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 S INDIANA AVE",
"city": "ENGLEWOOD",
"state": "FL",
"postal_code": "342233305",
"telephone_number": "941-473-7787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADSWORTH",
"first_name": "MARK",
"middle_name": "EDWARD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-01",
"last_updated": "2023-08-01",
"certification_date": "2023-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "FL",
"license": "RPT65160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Englewood, FL
- James Phillip Villotti Jr., M.D.
- Stephanie Vlahovic, ARNP
- Vincent G. Volpe, LMT, HHP
- Sonia Renee Wade Bannert
- James Wade, MD
- Wal-Mart Stores East LP (Walmart Pharmacy 10-1874)
- Wal-Mart Stores East, LP (Vision Center 30-1874)
- Walgreen Co (Walgreens #05859)
- Walgreen Co (Walgreens #07496)
- Mary Walker, SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.