Active NPI
Jordyn Veres
- Community/Retail Pharmacy
- Merritt Island, FL
National Provider Identifier
1235864687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PS64021
- Practice address
- 1587 N Courtenay Pkwy
Merritt Island, FL 32953-4454 - Phone
- (321) 459-1647
- NPI assigned
- Jul 20, 2022
- Last updated
- Jul 20, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | PS64021 | FL | Primary |
Addresses
Primary practice location
1587 N Courtenay Pkwy
Merritt Island, FL 32953-4454
Mailing address
2547 Kefauver St
Melbourne, FL 32935-2715
Phone (321) 872-5906
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 |
|---|---|---|---|
| PS64021 | FL | MD | Community/Retail Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Community/Retail Pharmacy | Current | Accepting new patients |
| Walgreen Co | Community/Retail Pharmacy | Past | Accepting new patients |
Locations
1587 N Courtenay Pkwy
Merritt Island, FL 32953
Phone (321) 459-1647
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": "1658275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658275200000",
"number": "1235864687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2547 KEFAUVER ST",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329352715",
"telephone_number": "321-872-5906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1587 N COURTENAY PKWY",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329534454",
"telephone_number": "321-459-1647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERES",
"first_name": "JORDYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-20",
"last_updated": "2022-07-20",
"certification_date": "2022-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "FL",
"license": "PS64021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merritt Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.