Individual provider Active NPI

Thomas W Nelson

  • Pharmacist
  • Melbourne, FL
National Provider Identifier
1346023694
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS66168 Issued in FL
Practice address
145 Palm Bay Rd NE Ste 117
Melbourne, FL 32904-8601
Phone
(321) 722-0022
NPI assigned
Aug 18, 2023
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS66168 FL Primary

Addresses

Primary practice location

145 Palm Bay Rd NE Ste 117
Melbourne, FL 32904-8601

Mailing address

2211 Bignonia St
Melbourne, FL 32901-5903
Phone (321) 501-1829

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

LicenseStateTypeSpecialty
PS66168FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1346023694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 BIGNONIA ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015903",
            "telephone_number": "321-501-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 PALM BAY RD NE STE 117",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329048601",
            "telephone_number": "321-722-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "THOMAS",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS66168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.