Active NPI
Joel Rivera, RPH
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1336580042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS 34352
- Practice address
- 1 Schircliff Way
Jacksonville, FL 32204 - Phone
- (904) 308-7515
- Fax
- (904) 308-7514
- NPI assigned
- Jul 10, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS 34352 | FL | Primary |
| Pharmacist | 183500000X | 046977-1 | NY |
Addresses
Primary practice location
1 Schircliff Way
Jacksonville, FL 32204
Mailing address
1 Schircliff Way
Jacksonville, FL 32204
Phone (904) 308-7515
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS 34352 | Other | FL | PHARMACIST LICENSE NUMBER |
| 046977-1 | Other | NY | NEW YORK PHARMACIST LICENSE NUMBER |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046977-1 | NY | MD | General Practice Dentistry |
| PS 34352 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400716800000",
"number": "1336580042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SCHIRCLIFF WAY",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32204",
"telephone_number": "904-308-7515",
"fax_number": "904-308-7514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 SCHIRCLIFF WAY",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32204",
"telephone_number": "904-308-7515",
"fax_number": "904-308-7514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "JOEL",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-10",
"last_updated": "2014-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS 34352",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "046977-1",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE NUMBER",
"identifier": "PS 34352",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK PHARMACIST LICENSE NUMBER",
"identifier": "046977-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}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 May 22, 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.