Paul William Jackson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS55200 Issued in FL

Practice address

226 N Nova Rd Ste 184
Ormond Beach, FL 32174-5124

Phone

(386) 235-1489

NPI assigned

Apr 26, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Care America at Maitland, LLC

  • Community/Retail Pharmacy
  • Orlando, FL
  • NPI 1689127862
  NPD (past)

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1326536277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 NW 7TH ST",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334429355",
            "telephone_number": "954-934-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 N NOVA RD STE 184",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745124",
            "telephone_number": "386-235-1489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "253 Bellagio Cir",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "FL",
            "postal_code": "327715001",
            "country_code": "US",
            "telephone_number": "407-865-7020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7960 Forest City Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328102938",
            "country_code": "US",
            "telephone_number": "407-865-7020",
            "fax_number": "407-865-7088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "PAUL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS55200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Island Telespeech, LLC
• J.C. Home Care Inc
• Richard A Jablonski, DO
• Patti Jean Jacke, M.A.
• Jackson Reef
• Jacksonville Spine Center PA
• Kian Fay Jacobs, LCSW
• Erika Leigh Jacumin, PA
• Jaideep Hoskote MD PA
• Christopher Colon Jaime, DPT,PT

• Pharmacist in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; 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.