Active NPI
Robert Jessie McDonald, RPH
- Pharmacist
- Chipley, FL
National Provider Identifier
1447856141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS19197
- Practice address
- CVS 04480
1037 Main St.
Chipley, FL 32428-0017 - Phone
- (850) 638-7896
- NPI assigned
- Dec 8, 2020
- Last updated
- Dec 8, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS19197 | FL | Primary |
Addresses
Primary practice location
CVS 04480
1037 Main St.
Chipley, FL 32428-0017
Mailing address
20813 NE McDonald LN
Blountstown, FL 32424-8115
Phone (850) 674-5285
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS19197 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS L.L.C. | 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": "1607385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607385600000",
"number": "1447856141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20813 NE MCDONALD LN",
"city": "BLOUNTSTOWN",
"state": "FL",
"postal_code": "324248115",
"telephone_number": "850-674-5285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CVS 04480",
"address_2": "1037 MAIN ST.",
"city": "CHIPLEY",
"state": "FL",
"postal_code": "324280017",
"telephone_number": "850-638-7896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "ROBERT",
"middle_name": "JESSIE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-08",
"last_updated": "2020-12-08",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS19197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chipley, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.