Individual provider Active NPI

Xuan T Duong, PHARMD, RPH

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1417414798
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS63606 Issued in FL
Practice address
12387 Yellow Bluff Rd
Jacksonville, FL 32226-2025
Phone
(904) 751-2744
NPI assigned
Feb 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 80286 CA
Pharmacist 183500000X PS63606 FL Primary

Addresses

Primary practice location

12387 Yellow Bluff Rd
Jacksonville, FL 32226-2025

Mailing address

12387 Yellow Bluff Rd
Jacksonville, FL 32226-2025
Phone (904) 751-2744

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
80286CAMDPharmacist
PS63606FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Jan 1, 2023 Accepting new patients
Walgreen Co PastSince Jan 1, 2023 Accepting new patients

Locations

12387 Yellow Bluff Rd
Jacksonville, FL 32226
Phone (904) 751-2744

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1417414798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12387 YELLOW BLUFF RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322262025",
            "telephone_number": "904-751-2744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12387 YELLOW BLUFF RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322262025",
            "telephone_number": "904-751-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "XUAN",
        "middle_name": "T",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "80286",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS63606",
            "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 Dec 30, 2022; 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.