Individual provider Active NPI

Nora Waryoba, RPH

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1356024038
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS66090 Issued in FL
Practice address
4413 Town Center Pkwy Ste 100
Jacksonville, FL 32246-8570
Phone
(850) 564-3790
NPI assigned
Aug 9, 2023
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 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 PS66090 FL Primary

Addresses

Primary practice location

4413 Town Center Pkwy Ste 100
Jacksonville, FL 32246-8570

Mailing address

4870 Deer Lake Dr E Ste 4305
Jacksonville, FL 32246-6322
Phone (850) 345-6692

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

LicenseStateTypeSpecialty
PS66090FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1356024038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4870 DEER LAKE DR E STE 4305",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322466322",
            "telephone_number": "850-345-6692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4413 TOWN CENTER PKWY STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468570",
            "telephone_number": "850-564-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARYOBA",
        "first_name": "NORA",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS66090",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 9, 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.