Active NPI
Richard Jay Roberts, PHARM.D.
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1548507494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS16103
- Practice address
- 4495 Roosevelt Blvd
E1
Jacksonville, FL 32210-3375 - Phone
- (904) 388-1316
- Fax
- (904) 388-4713
- NPI assigned
- Jan 12, 2013
- 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 | PS16103 | FL | Primary |
Addresses
Primary practice location
4495 Roosevelt Blvd
E1
Jacksonville, FL 32210-3375
Mailing address
4495 Roosevelt Blvd
E1
Jacksonville, FL 32210-3375
Phone (904) 388-1316
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 |
|---|---|---|---|
| PS16103 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357948800000",
"number": "1548507494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4495 ROOSEVELT BLVD",
"address_2": "E1",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322103375",
"telephone_number": "904-388-1316",
"fax_number": "904-388-4713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4495 ROOSEVELT BLVD",
"address_2": "E1",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322103375",
"telephone_number": "904-388-1316",
"fax_number": "904-388-4713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "RICHARD",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-12",
"last_updated": "2013-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS16103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.