NPIMap

Individual provider Active NPI

Marilyn Medina, PHARMD

  • Pharmacist
  • Slidell, LA
National Provider Identifier
1467997379
Registry record updated Jan 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS.021786 Issued in LA
Practice address
1305 Gause Blvd
Slidell, LA 70458-3015
Phone
(985) 641-2550
NPI assigned
Jan 1, 2017
Last updated
Jan 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS.021786 LA Primary
Pharmacist 183500000X PS53479 FL

Addresses

Primary practice location

1305 Gause Blvd
Slidell, LA 70458-3015

Mailing address

10501 Curran Blvd Apt 13D
New Orleans, LA 70127-5153
Phone (786) 302-7516

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
PS53479FLMDPharmacist
PS.021786LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana CVS Pharmacy, L.L.C. Past Accepting new patients
Louisiana CVS Pharmacy LLC 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": "1483228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483228800000",
    "number": "1467997379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 CURRAN BLVD APT 13D",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701275153",
            "telephone_number": "786-302-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 GAUSE BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704583015",
            "telephone_number": "985-641-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "MARILYN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-01",
        "last_updated": "2017-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PS.021786",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS53479",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2017; 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.