Active NPI
Kwadwo Attakora
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1265156251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS58804
- Practice address
- 13125 N Main St
Jacksonville, FL 32218-2759 - Phone
- (904) 596-1653
- NPI assigned
- Oct 3, 2022
- Last updated
- Oct 3, 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 | PS58804 | FL | Primary |
Addresses
Primary practice location
13125 N Main St
Jacksonville, FL 32218-2759
Mailing address
13125 N Main St
Jacksonville, FL 32218-2759
Phone (904) 596-1653
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | intercom | Direct |
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 |
|---|---|---|---|
| PS58804 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co. | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
13125 N Main St
Jacksonville, FL 32218
Phone (904) 596-1653
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": "1664755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664755200000",
"number": "1265156251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13125 N MAIN ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322182759",
"telephone_number": "904-596-1653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13125 N MAIN ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322182759",
"telephone_number": "904-596-1653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATTAKORA",
"first_name": "KWADWO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-03",
"last_updated": "2022-10-03",
"certification_date": "2022-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS58804",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "intercom",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "13125 N Main St",
"city": "Jacksonville",
"state": "FL",
"country_code": "US",
"postal_code": "322182759",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.