Active NPI
Jimmy Sam George, REG. PHARMACIST
- Pharmacist
- Bartow, FL
National Provider Identifier
1275771271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS36391
- Practice address
- 155 E Van Fleet Dr
Bartow, FL 33830-3829 - Phone
- (863) 533-6669
- Fax
- (863) 533-1963
- NPI assigned
- Jan 29, 2009
- Last updated
- Jan 29, 2009
- 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 | PS36391 | FL | Primary |
Addresses
Primary practice location
155 E Van Fleet Dr
Bartow, FL 33830-3829
Mailing address
155 E Van Fleet Dr
Bartow, FL 33830-3829
Phone (863) 533-6669
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 |
|---|---|---|---|
| PS36391 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | 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, 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": "1233187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233187200000",
"number": "1275771271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 E VAN FLEET DR",
"city": "BARTOW",
"state": "FL",
"postal_code": "338303829",
"telephone_number": "863-533-6669",
"fax_number": "863-533-1963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 E VAN FLEET DR",
"city": "BARTOW",
"state": "FL",
"postal_code": "338303829",
"telephone_number": "863-533-6669",
"fax_number": "863-533-1963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "JIMMY",
"middle_name": "SAM",
"name_prefix": "Mr.",
"credential": "REG. PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-29",
"last_updated": "2009-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS36391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bartow, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.