Individual provider Active NPI

Buddy Kyle Chesnut, RPH

  • Pharmacist
  • Panama City Beach, FL
National Provider Identifier
1396083762
Registry record updated Jan 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS32914 Issued in FL
Practice address
11240 Panama City Beach Pkwy
Panama City Beach, FL 32407-2449
Phone
(850) 233-4590
NPI assigned
Jan 19, 2013
Last updated
Jan 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 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 PS32914 FL Primary

Addresses

Primary practice location

11240 Panama City Beach Pkwy
Panama City Beach, FL 32407-2449

Mailing address

11240 Panama City Beach Pkwy
Panama City Beach, FL 32407-2449
Phone (850) 233-4590

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
PS32914FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets Inc Past Accepting new patients
Publix Super Markets Inc 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": "1358553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358553600000",
    "number": "1396083762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11240 PANAMA CITY BEACH PKWY",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072449",
            "telephone_number": "850-233-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 PANAMA CITY BEACH PKWY",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072449",
            "telephone_number": "850-233-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESNUT",
        "first_name": "BUDDY",
        "middle_name": "KYLE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-19",
        "last_updated": "2013-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS32914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.