Individual provider Active NPI

Robert F Johnson, RPH

  • Pharmacist
  • Kissimmee, FL
National Provider Identifier
1457430316
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS28897 Issued in FL
Practice address
2701 Michigan Ave
Suite B
Kissimmee, FL 34744-1214
Phone
(407) 343-1230
Fax
(407) 343-1238
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS28897 FL Primary

Addresses

Primary practice location

2701 Michigan Ave
Suite B
Kissimmee, FL 34744-1214

Mailing address

4943 Keaton Crest Dr
Orlando, FL 32837-4938
Phone (407) 888-9246

Other identifiers 1

IdentifierTypeStateIssuer
PS28897OtherFLPHARMACIST LICENSE

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

LicenseStateTypeSpecialty
PS28897FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457430316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4943 KEATON CREST DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328374938",
            "telephone_number": "407-888-9246",
            "fax_number": "407-343-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 MICHIGAN AVE",
            "address_2": "SUITE B",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441214",
            "telephone_number": "407-343-1230",
            "fax_number": "407-343-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROBERT",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS28897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PS28897",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.