NPIMap

Organization Active NPI

Complete 180

  • Pharmacotherapy Pharmacist
  • Jacksonville, FL
National Provider Identifier
1346630761
Registry record updated Jan 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
PU6243 Issued in FL
Legal business name
COMPLETE 180
Practice address
4750 Soutel Dr
Suite &
Jacksonville, FL 32208-8510
Phone
(352) 255-2695
NPI assigned
Jan 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2015

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

Authorized official

Name
Erika Jasper, PHARM. D
Title
Owner
Phone
(352) 255-2695

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 183500000X PS36762 FL
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1835P0018X PU6243 FL
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1835P0018X 55903 TX
Pharmacotherapy PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1835P1200X PU6243 FL Primary

Addresses

Primary practice location

4750 Soutel Dr
Suite &
Jacksonville, FL 32208-8510

Mailing address

PO Box 57411
Jacksonville, FL 32241-7411
Phone (352) 255-2695

Other names 1

  • Complete 180 LLC Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1422057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422057600000",
    "number": "1346630761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57411",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322417411",
            "telephone_number": "352-255-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 SOUTEL DR",
            "address_2": "SUITE &",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322088510",
            "telephone_number": "352-255-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE 180",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-24",
        "last_updated": "2015-01-24",
        "status": "A",
        "authorized_official_last_name": "JASPER",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-255-2695",
        "authorized_official_credential": "PHARM. D"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS36762",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PU6243",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "55903",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "FL",
            "license": "PU6243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete 180 LLC",
            "code": "4",
            "type": "Former Legal Business 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 Jan 24, 2015; 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.