Individual provider Active NPI

Joann Jaramillo Coburn

  • Pharmacy Technician
  • Austin, TX
National Provider Identifier
1417625039
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
145200 Issued in TX
Practice address
500 Canyon Ridge Dr
Austin, TX 78753-1632
Phone
(512) 973-8753
NPI assigned
Aug 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 145200 TX Primary

Addresses

Primary practice location

500 Canyon Ridge Dr
Austin, TX 78753-1632

Mailing address

500 Canyon Ridge Dr
Austin, TX 78753-1632
Phone (512) 973-8753

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL NA
CONNECT URL NA

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
145200TXMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1417625039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CANYON RIDGE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787531632",
            "telephone_number": "512-973-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CANYON RIDGE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787531632",
            "telephone_number": "512-973-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBURN",
        "first_name": "JOANN",
        "middle_name": "JARAMILLO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "TX",
            "license": "145200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "500 Canyon Ridge Dr",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787531632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "500 Canyon Ridge Dr",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787531632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.