Active NPI
Jack Nounoume
- Pharmacist
- West Palm Beach, FL
National Provider Identifier
1245972686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS63827
- Practice address
- 2200 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-3402 - Phone
- (561) 507-8480
- NPI assigned
- Apr 7, 2022
- Sex
- Male
- 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 | PS63827 | FL | Primary |
Addresses
Primary practice location
2200 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-3402
Mailing address
2200 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-3402
Phone (561) 507-8480
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 |
|---|---|---|---|
| PS63827 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649289600000",
"number": "1245972686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 PALM BEACH LAKES BLVD",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334093402",
"telephone_number": "561-507-8480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 PALM BEACH LAKES BLVD",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334093402",
"telephone_number": "561-507-8480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOUNOUME",
"first_name": "JACK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-07",
"last_updated": "2022-04-07",
"certification_date": "2022-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS63827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.