Active NPI
Jordan Thomas
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1336541994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17850
- Practice address
- 2080 Child St
Jacksonville, FL 32214-6050 - Phone
- (904) 542-7442
- NPI assigned
- Sep 25, 2014
- Last updated
- Sep 25, 2014
- 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 | 17850 | AL | Primary |
Addresses
Primary practice location
2080 Child St
Jacksonville, FL 32214-6050
Mailing address
674 Glendale LN
Orange Park, FL 32065-5626
Phone (205) 534-0599
Other names 1
- Dr. Jordan Thomas
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17850 | AL | MD | Preventive Medicine/Occupational Environmental Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411603200000",
"number": "1336541994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "674 GLENDALE LN",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320655626",
"telephone_number": "205-534-0599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2080 CHILD ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322146050",
"telephone_number": "904-542-7442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "JORDAN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-25",
"last_updated": "2014-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "17850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JORDAN",
"last_name": "THOMAS",
"prefix": "DR.",
"credential": "PHARMD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.