Active NPI
Rukiya R Roberson, PHARM D
- Pharmacist
- Ormond Beach, FL
National Provider Identifier
1346522588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS0034223
- Practice address
- 790 W Granada Blvd
Ormond Beach, FL 32174-5178 - Phone
- (386) 672-7107
- NPI assigned
- Sep 14, 2011
- Last updated
- Sep 14, 2011
- Sex
- Female
- Sole proprietor
- No
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 | PS0034223 | FL | Primary |
| Pharmacist | 183500000X | RPH024761 | GA |
Addresses
Primary practice location
790 W Granada Blvd
Ormond Beach, FL 32174-5178
Mailing address
790 W Granada Blvd
Ormond Beach, FL 32174-5178
Phone (386) 672-7107
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS0034223 | FL | MD | Pharmacist |
| RPH024761 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315958400000",
"number": "1346522588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 W GRANADA BLVD",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321745178",
"telephone_number": "386-672-7107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 W GRANADA BLVD",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321745178",
"telephone_number": "386-672-7107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERSON",
"first_name": "RUKIYA",
"middle_name": "R",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-14",
"last_updated": "2011-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS0034223",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH024761",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.