Active NPI
Matt Weinberg
- Pharmacist
- Palm Coast, FL
National Provider Identifier
1255927331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS33811
- Practice address
- 1 Old Kings Rd
Palm Coast, FL 32137-4613 - Phone
- (385) 415-0866
- NPI assigned
- Dec 14, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS032811 | FL | |
| Pharmacist | 183500000X | PS33811 | FL | Primary |
Addresses
Primary practice location
1 Old Kings Rd
Palm Coast, FL 32137-4613
Mailing address
1 Old Kings Rd
Palm Coast, FL 32137-4613
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 |
|---|---|---|---|
| PS032811 | FL | MD | Pharmacist |
| PS33811 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607904000000",
"number": "1255927331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 OLD KINGS RD",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321374613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 OLD KINGS RD",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321374613",
"telephone_number": "385-415-0866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEINBERG",
"first_name": "MATT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-14",
"last_updated": "2020-12-14",
"certification_date": "2020-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS032811",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS33811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Coast, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.