Individual provider Active NPI

Craig Brubaker, PHARMD

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1356688402
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS48950 Issued in FL
Practice address
731 Duval Station Rd
Ste 4
Jacksonville, FL 32218-0800
Phone
(904) 696-3363
NPI assigned
Jan 9, 2013
Last updated
Jan 9, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS48950 FL Primary

Addresses

Primary practice location

731 Duval Station Rd
Ste 4
Jacksonville, FL 32218-0800

Mailing address

731 Duval Station Rd
Ste 4
Jacksonville, FL 32218-0800
Phone (904) 696-3363

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

LicenseStateTypeSpecialty
PS48950FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1356688402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 DUVAL STATION RD",
            "address_2": "STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322180800",
            "telephone_number": "904-696-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 DUVAL STATION RD",
            "address_2": "STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322180800",
            "telephone_number": "904-696-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "CRAIG",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS48950",
            "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 Jan 9, 2013; 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.