Individual provider Active NPI

John Tumba Tshimbalanga

  • Pharmacist
  • Orange Park, FL
National Provider Identifier
1447726054
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS51238 Issued in FL
Practice address
638 Briar View Dr
Orange Park, FL 32065-3556
Phone
(904) 520-2908
NPI assigned
Oct 22, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X PS51238 FL Primary

Addresses

Primary practice location

638 Briar View Dr
Orange Park, FL 32065-3556

Mailing address

638 Briar View Dr
Orange Park, FL 32065-3556
Phone (904) 520-2908

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
PS51238FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1447726054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 BRIAR VIEW DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320653556",
            "telephone_number": "904-520-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 BRIAR VIEW DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320653556",
            "telephone_number": "904-520-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSHIMBALANGA",
        "first_name": "JOHN",
        "middle_name": "TUMBA",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS51238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.