Individual provider Active NPI

Jody R Welchans

  • Pharmacist
  • San Antonio, TX
National Provider Identifier
1376811562
Registry record updated Dec 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
36873 Issued in TX
Practice address
1303 McCullough Ave Ste 128
San Antonio, TX 78212-5603
Phone
(210) 354-3993
Fax
(210) 354-2496
NPI assigned
Dec 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 36873 TX Primary

Addresses

Primary practice location

1303 McCullough Ave Ste 128
San Antonio, TX 78212-5603

Mailing address

1303 McCullough Ave Ste 128
San Antonio, TX 78212-5603
Phone (210) 354-3993

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
36873TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CBK Pharmacy LLC Current Accepting new patients
CBK Pharmacy LLC Current Accepting new patients
TXRX LLC Dba Fiestarx Current Accepting new patients
Wholesale Grocery Services PastSince May 1, 2020 Accepting new patients

Locations

1303 McCullough Ave
Ste 128
San Antonio, TX 78212
Phone (210) 227-7207

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734220800000",
    "number": "1376811562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE STE 128",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125603",
            "telephone_number": "210-354-3993",
            "fax_number": "210-354-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE STE 128",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125603",
            "telephone_number": "210-354-3993",
            "fax_number": "210-354-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCHANS",
        "first_name": "JODY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-02",
        "last_updated": "2024-12-15",
        "certification_date": "2024-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "36873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2024; 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.