Active NPI
Jonah Kobelin, PHARMD, RPH, CPH
- Pharmacist
- Holly Hill, FL
National Provider Identifier
1326648627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS43105
- Practice address
- 1905 N Nova Rd
Holly Hill, FL 32117-1421 - Phone
- (386) 672-8955
- NPI assigned
- Oct 27, 2020
- Last updated
- Oct 27, 2020
- 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 | PS43105 | FL | Primary |
Addresses
Primary practice location
1905 N Nova Rd
Holly Hill, FL 32117-1421
Mailing address
36 Waterbluff Dr
Ormond Beach, FL 32174-3075
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS43105 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Current | Accepting new patients | |
| Wal-Mart Stores East, LP | Past | Accepting new patients |
Locations
1905 N Nova Rd
Holly Hill, FL 32117
Phone (386) 672-8955
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Walmart Pharmacy 10-3862
- Community/Retail Pharmacy
- Daytona Beach, FL
- NPI 1215948732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603756800000",
"number": "1326648627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 WATERBLUFF DR",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321743075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 N NOVA RD",
"city": "HOLLY HILL",
"state": "FL",
"postal_code": "321171421",
"telephone_number": "386-672-8955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOBELIN",
"first_name": "JONAH",
"name_prefix": "Dr.",
"credential": "PHARMD, RPH, CPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-27",
"last_updated": "2020-10-27",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS43105",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holly Hill, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.