Individual provider Active NPI

Edward Tootell Jr., RPH

  • Pharmacist
  • Columbus, NJ
National Provider Identifier
1265029359
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI16058 Issued in NJ
Practice address
23202 Columbus Rd Ste E
Columbus, NJ 08022-1982
Phone
(609) 298-7474
Fax
(609) 298-6811
NPI assigned
Dec 23, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI16058 NJ Primary

Addresses

Primary practice location

23202 Columbus Rd Ste E
Columbus, NJ 08022-1982

Mailing address

23202 Columbus Rd Ste E
Columbus, NJ 08022-1982
Phone (609) 298-7474

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI16058NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Boyd'S Pharmacy of Mansfield, Inc CurrentSince Nov 10, 2024 Accepting new patients
Boyd'S Pharmacy of Mansfield, Inc Pharmacist PastSince Dec 27, 2020 Accepting new patients

Locations

23202 Columbus Rd
Ste E
Columbus, NJ 08022
Phone (609) 298-7474

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": "1608681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1265029359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23202 COLUMBUS RD STE E",
            "city": "COLUMBUS",
            "state": "NJ",
            "postal_code": "080221982",
            "telephone_number": "609-298-7474",
            "fax_number": "609-298-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23202 COLUMBUS RD STE E",
            "city": "COLUMBUS",
            "state": "NJ",
            "postal_code": "080221982",
            "telephone_number": "609-298-7474",
            "fax_number": "609-298-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOOTELL",
        "first_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI16058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.

Verify at the official NPI Registry.