Active NPI
Lisa M Libby, RPH
- Pharmacist
- Daytona Beach Shores, FL
National Provider Identifier
1497036917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS0025889
- Practice address
- 3004 S Atlantic Ave
Daytona Beach Shores, FL 32118-6102 - Phone
- (386) 788-6344
- Fax
- (386) 788-8703
- NPI assigned
- Aug 30, 2011
- Last updated
- Aug 30, 2011
- Sex
- Female
- 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 | PS0025889 | FL | Primary |
Addresses
Primary practice location
3004 S Atlantic Ave
Daytona Beach Shores, FL 32118-6102
Mailing address
3004 S Atlantic Ave
Daytona Beach Shores, FL 32118-6102
Phone (386) 788-6344
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 |
|---|---|---|---|
| PS0025889 | 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": "1314662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314662400000",
"number": "1497036917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3004 S ATLANTIC AVE",
"city": "DAYTONA BEACH SHORES",
"state": "FL",
"postal_code": "321186102",
"telephone_number": "386-788-6344",
"fax_number": "386-788-8703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3004 S ATLANTIC AVE",
"city": "DAYTONA BEACH SHORES",
"state": "FL",
"postal_code": "321186102",
"telephone_number": "386-788-6344",
"fax_number": "386-788-8703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIBBY",
"first_name": "LISA",
"middle_name": "M",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-30",
"last_updated": "2011-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS0025889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daytona Beach Shores, FL
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- Deborah Arlt Klug
- Athas Nicholas Kometas, DMD
- Lake Diabetes Supply, Inc
- Jessica W. Macginnis, BCBA
- Marcella Scaccia Physician PLLC (Total Wellness & Healthy Aging)
- Marina Dental Center Inc.
- Madeline McCullen
- Carla McNabb
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.