Active NPI
Jonah Tom, PHARMD
- Pharmacist
- Hollywood, FL
National Provider Identifier
1548864697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS55376
- Practice address
- 3400 Hollywood Blvd
Hollywood, FL 33021-6911 - Phone
- (954) 987-5901
- NPI assigned
- Nov 29, 2020
- Last updated
- Nov 29, 2020
- 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 | PS55376 | FL | Primary |
Addresses
Primary practice location
3400 Hollywood Blvd
Hollywood, FL 33021-6911
Mailing address
13372 NW 11TH St
Pembroke Pines, FL 33028-2704
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jonah.tom@cvshealth.com | Direct | CVS Pharmacy, Inc |
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 |
|---|---|---|---|
| PS55376 | 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 |
Interoperability endpoints
- jonah.tom@cvshealth.com
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": "1606608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606608000000",
"number": "1548864697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13372 NW 11TH ST",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330282704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 HOLLYWOOD BLVD",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330216911",
"telephone_number": "954-987-5901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOM",
"first_name": "JONAH",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-29",
"last_updated": "2020-11-29",
"certification_date": "2020-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS55376",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jonah.tom@cvshealth.com",
"affiliation": "Y",
"affiliationName": "CVS Pharmacy, Inc",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3400 Hollywood Blvd",
"city": "Hollywood",
"state": "FL",
"country_code": "US",
"postal_code": "330216911",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.