Active NPI
Thomas Howard Baggett, RPH
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1194447169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS19638
- Practice address
- 5634 Merrill Rd
Jacksonville, FL 32277-3306 - Phone
- (904) 743-0109
- NPI assigned
- Sep 15, 2022
- Sex
- Male
- Sole proprietor
- No
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 | PS19638 | FL | Primary |
Addresses
Primary practice location
5634 Merrill Rd
Jacksonville, FL 32277-3306
Mailing address
504 W Dandridge LN
St Johns, FL 32259-6907
Phone (239) 287-7555
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS19638 | 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": "1663200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663200000000",
"number": "1194447169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 W DANDRIDGE LN",
"city": "ST JOHNS",
"state": "FL",
"postal_code": "322596907",
"telephone_number": "239-287-7555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5634 MERRILL RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322773306",
"telephone_number": "904-743-0109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGGETT",
"first_name": "THOMAS",
"middle_name": "HOWARD",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-15",
"last_updated": "2022-09-15",
"certification_date": "2022-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS19638",
"primary": true
}
],
"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 Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.