Active NPI
Justis Cummins, PHARMD
- Pharmacist
- Jensen Beach, FL
National Provider Identifier
1508589508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS62959
- Practice address
- 1255 NE Jensen Beach Blvd
Jensen Beach, FL 34957-7221 - Phone
- (772) 334-4204
- NPI assigned
- Sep 23, 2022
- Last updated
- Sep 23, 2022
- Sex
- Male
- Sole proprietor
- No
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 | PS62959 | FL | Primary |
Addresses
Primary practice location
1255 NE Jensen Beach Blvd
Jensen Beach, FL 34957-7221
Mailing address
6305 S Header Canal Rd
Fort Pierce, FL 34987-3119
Other practice location 1
1255 NE Jensen Beach Blvd
Jensen Beach, FL 34957-7221
Phone (772) 334-4204
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS62959 | 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": "1663891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663891200000",
"number": "1508589508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6305 S HEADER CANAL RD",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349873119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1255 NE JENSEN BEACH BLVD",
"city": "JENSEN BEACH",
"state": "FL",
"postal_code": "349577221",
"telephone_number": "772-334-4204"
}
],
"practiceLocations": [
{
"address_1": "1255 NE Jensen Beach Blvd",
"address_purpose": "LOCATION",
"city": "Jensen Beach",
"state": "FL",
"postal_code": "349577221",
"country_code": "US",
"telephone_number": "772-334-4204",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CUMMINS",
"first_name": "JUSTIS",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-23",
"last_updated": "2022-09-23",
"certification_date": "2022-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS62959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jensen Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.