Individual provider Active NPI

Jon Ross Cornejo Del Rosario, PHARMD

  • Pharmacist
  • Austin, TX
National Provider Identifier
1285282954
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
65569 Issued in TX
Practice address
5345 N Ih 35
Austin, TX 78723-2428
Phone
(512) 452-9452
NPI assigned
Aug 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 65569 TX Primary

Addresses

Primary practice location

5345 N Ih 35
Austin, TX 78723-2428

Mailing address

9417 Great Hills TRL Apt 1059
Austin, TX 78759-6346
Phone (956) 453-5904

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
65569TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Mar 13, 2022 Accepting new patients
Walgreen Co PastSince Sep 1, 2019 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": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1285282954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9417 GREAT HILLS TRL APT 1059",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787596346",
            "telephone_number": "956-453-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5345 N IH 35",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787232428",
            "telephone_number": "512-452-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL ROSARIO",
        "first_name": "JON ROSS",
        "middle_name": "CORNEJO",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "65569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.