Individual provider Active NPI

Jaime Wiens, PHARMD

  • Pharmacist
  • Indialantic, FL
National Provider Identifier
1437759743
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS40030 Issued in FL
Practice address
700 N Miramar Ave
Indialantic, FL 32903-3002
Phone
(321) 339-5012
NPI assigned
Oct 27, 2020
Last updated
Oct 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS40030 FL Primary

Addresses

Primary practice location

700 N Miramar Ave
Indialantic, FL 32903-3002

Mailing address

700 N Miramar Ave
Indialantic, FL 32903-3002
Phone (321) 339-5012

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
PS40030FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Publix Super Markets Inc PastSince Nov 1, 2020 Accepting new patients

Locations

700 N Miramar Ave
Indialantic, FL 32903
Phone (321) 339-5012

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": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1437759743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N MIRAMAR AVE",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329033002",
            "telephone_number": "321-339-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N MIRAMAR AVE",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329033002",
            "telephone_number": "321-339-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENS",
        "first_name": "JAIME",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS40030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indialantic, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.