Active NPI
Anthony G Bynum Kissee, PHARM'D
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1225626716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS56330
- Practice address
- 7431 Atlantic Blvd
Jacksonville, FL 32211-8712 - Phone
- (904) 722-2151
- NPI assigned
- Jan 9, 2021
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS56330 | FL | Primary |
Addresses
Primary practice location
7431 Atlantic Blvd
Jacksonville, FL 32211-8712
Mailing address
4277 Studio Park Ave
Jacksonville, FL 32216-1018
Phone (267) 886-3210
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS56330 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS L.L.C. | 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": "1610150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610150400000",
"number": "1225626716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4277 STUDIO PARK AVE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322161018",
"telephone_number": "267-886-3210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7431 ATLANTIC BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322118712",
"telephone_number": "904-722-2151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYNUM KISSEE",
"first_name": "ANTHONY",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "PHARM'D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-09",
"last_updated": "2021-01-09",
"certification_date": "2021-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS56330",
"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 Jan 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.