Individual provider Active NPI

Dayamie Othello, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Mobile, AL
National Provider Identifier
1194455196
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PS62713 Issued in FL
Practice address
4444 Demetropolis Rd
Mobile, AL 36619-9602
Phone
(251) 574-8578
NPI assigned
Jun 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PS62713 FL Primary

Addresses

Primary practice location

4444 Demetropolis Rd
Mobile, AL 36619-9602

Mailing address

4444 Demetropolis Rd
Mobile, AL 36619-9602
Phone (251) 219-3900

Other practice location 1

790 Veterans Way
Pensacola, FL 32507-1000
Phone (850) 912-2115

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Other Health Information Exchange (HIE)

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS62713FLMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1194455196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 DEMETROPOLIS RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366199602",
            "telephone_number": "251-219-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 DEMETROPOLIS RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366199602",
            "telephone_number": "251-574-8578"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 Veterans Way",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325071000",
            "country_code": "US",
            "telephone_number": "850-912-2115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTHELLO",
        "first_name": "DAYAMIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS62713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Other",
            "affiliation": "N",
            "endpointDescription": "Other",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "790 Veterans Way",
            "city": "Pensacola",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325071000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.

Verify at the official NPI Registry.