Individual provider Active NPI

Jon Devon Ubelhor, PHARMD

  • Pharmacist
  • Austin, TX
National Provider Identifier
1326643305
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
50101 Issued in TX
Practice address
2900 W Anderson LN Ste 10
Austin, TX 78757-1165
Phone
(512) 452-7693
NPI assigned
Nov 30, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 50101 TX Primary

Addresses

Primary practice location

2900 W Anderson LN Ste 10
Austin, TX 78757-1165

Mailing address

2900 W Anderson LN Ste 10
Austin, TX 78757-1165

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL none

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
50101TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Pharmacy Inc PastSince Dec 6, 2020 Accepting new patients
CVS Pharmacy Inc PastSince Dec 6, 2020 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": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1326643305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 W ANDERSON LN STE 10",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787571165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W ANDERSON LN STE 10",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787571165",
            "telephone_number": "512-452-7693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UBELHOR",
        "first_name": "JON",
        "middle_name": "DEVON",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "50101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "none",
            "affiliation": "N",
            "address_1": "2900 W Anderson Ln Ste 10",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787571165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 30, 2020; 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.