Individual provider Active NPI

Joseph R. Davis II, PHARMD

  • Pharmacist
  • Fort Lauderdale, FL
National Provider Identifier
1265714182
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS42872 Issued in FL
Practice address
3895 W Broward Blvd
Fort Lauderdale, FL 33312
Phone
(954) 316-6641
NPI assigned
Sep 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS42872 FL Primary

Addresses

Primary practice location

3895 W Broward Blvd
Fort Lauderdale, FL 33312

Mailing address

12677 NW 17TH PL
Coral Springs, FL 33071-5407
Phone (954) 330-6622

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS42872FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew 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": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1265714182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12677 NW 17TH PL",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330715407",
            "telephone_number": "954-330-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3895 W BROWARD BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33312",
            "telephone_number": "954-316-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOSEPH",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-16",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS42872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.