Active NPI
Theron Douglas, PHARMD
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1235589888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS53880
- Practice address
- 4459 Whispering Inlet Dr
Jacksonville, FL 32277-1136 - Phone
- (352) 368-1886
- NPI assigned
- Jun 14, 2016
- Last updated
- Jul 26, 2016
- 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 | PS53880 | FL | Primary |
Addresses
Primary practice location
4459 Whispering Inlet Dr
Jacksonville, FL 32277-1136
Mailing address
2010 SW College Rd
Ocala, FL 34471-1620
Phone (352) 368-1886
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 |
|---|---|---|---|
| PS53880 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | 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": "1465862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469491200000",
"number": "1235589888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2010 SW COLLEGE RD",
"city": "OCALA",
"state": "FL",
"postal_code": "344711620",
"telephone_number": "352-368-1886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4459 WHISPERING INLET DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322771136",
"telephone_number": "352-368-1886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "THERON",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-14",
"last_updated": "2016-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS53880",
"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 Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.