Active NPI
David Anthony Derby
- Pharmacist
- Hollywood, FL
National Provider Identifier
1457636102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS30659
- Practice address
- 6817 Taft St
Hollywood, FL 33024-5601 - Phone
- (954) 989-8900
- Fax
- (954) 989-6406
- NPI assigned
- Oct 13, 2011
- Last updated
- Oct 13, 2011
- 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 | PS30659 | FL | Primary |
Addresses
Primary practice location
6817 Taft St
Hollywood, FL 33024-5601
Mailing address
6817 Taft St
Hollywood, FL 33024-5601
Phone (954) 989-8900
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS30659 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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": "1318464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318464000000",
"number": "1457636102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6817 TAFT ST",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330245601",
"telephone_number": "954-989-8900",
"fax_number": "954-989-6406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6817 TAFT ST",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330245601",
"telephone_number": "954-989-8900",
"fax_number": "954-989-6406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERBY",
"first_name": "DAVID",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-13",
"last_updated": "2011-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS30659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
- Dentists of Hollywood, PA (Dentists of Hollywood)
- Lenie Apolinario Depamaylo, APRN
- Yudelka Depena, ITDS
- Amy Christian Deramo, AGACNP-BC
- Shantrell Britany Derazin
- Cindy Sayonara Derequito, APRN
- Deborah Dergan, M.D.
- Dermatology Group of Florida PA
- Dermatology Group of Florida PA
- Dermatology Group of Florida PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.