Active NPI
Jojo K Jacob
- Pharmacist
- Plant City, FL
National Provider Identifier
1255935755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS0033199
- Practice address
- 2302 James L Redman Pkwy
Plant City, FL 33563-7109 - Phone
- (813) 752-3139
- NPI assigned
- Nov 24, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS0033199 | FL | Primary |
Addresses
Primary practice location
2302 James L Redman Pkwy
Plant City, FL 33563-7109
Mailing address
1109 Glen Park LN
Valrico, FL 33594-5112
Phone (813) 956-6703
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 |
|---|---|---|---|
| PS0033199 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS L.L.C. | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606176000000",
"number": "1255935755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1109 GLEN PARK LN",
"city": "VALRICO",
"state": "FL",
"postal_code": "335945112",
"telephone_number": "813-956-6703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2302 JAMES L REDMAN PKWY",
"city": "PLANT CITY",
"state": "FL",
"postal_code": "335637109",
"telephone_number": "813-752-3139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "JOJO",
"middle_name": "K",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-24",
"last_updated": "2020-11-24",
"certification_date": "2020-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS0033199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plant City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.