Individual provider Active NPI

Karl Harold Marcellus, PHARMD

  • Pharmacist
  • Orange Park, FL
National Provider Identifier
1306383070
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
55992 Issued in FL
Practice address
3175 Tower Oaks Dr
Orange Park, FL 32065-2548
Phone
(516) 784-9120
NPI assigned
Jan 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 55992 FL Primary

Addresses

Primary practice location

3175 Tower Oaks Dr
Orange Park, FL 32065-2548

Mailing address

3175 Tower Oaks Dr
Orange Park, FL 32065-2548
Phone (516) 784-9120

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
55992FLMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1306383070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 TOWER OAKS DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652548",
            "telephone_number": "516-784-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 TOWER OAKS DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652548",
            "telephone_number": "516-784-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELLUS",
        "first_name": "KARL",
        "middle_name": "HAROLD",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "55992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.