Active NPI
Audreyole Gillians
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1205117413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS41833
- Practice address
- 2405 Mayport Rd
Jacksonville, FL 32233-6390 - Phone
- (904) 435-0509
- NPI assigned
- Aug 31, 2011
- Sex
- Female
- 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 | PS41833 | FL | Primary |
Addresses
Primary practice location
2405 Mayport Rd
Jacksonville, FL 32233-6390
Mailing address
2405 Mayport Rd
Atlantic Beach, FL 32233-6390
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 |
|---|---|---|---|
| PS41833 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
2405 Mayport Rd
Jacksonville, FL 32233
Phone (904) 254-7209
Organizations & group practices 3
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": "1314748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671148800000",
"number": "1205117413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2405 MAYPORT RD",
"city": "ATLANTIC BEACH",
"state": "FL",
"postal_code": "322336390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2405 MAYPORT RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322336390",
"telephone_number": "904-435-0509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIANS",
"first_name": "AUDREYOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-31",
"last_updated": "2022-12-16",
"certification_date": "2022-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS41833",
"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 Dec 16, 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.