Individual provider Active NPI

Jason Maynard, PHARMD

  • Pharmacist
  • Warwick, RI
National Provider Identifier
1568066843
Registry record updated Nov 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
06057 Issued in RI
Practice address
767 Warwick Ave
Warwick, RI 02888-2601
Phone
(401) 467-7788
NPI assigned
Nov 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 06057 RI Primary

Addresses

Primary practice location

767 Warwick Ave
Warwick, RI 02888-2601

Mailing address

767 Warwick Ave
Warwick, RI 02888-2601
Phone (401) 467-7788

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL other

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
06057RIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island CVS Pharmacy LLC PastSince Nov 29, 2020 Accepting new patients
Rhode Island CVS Pharmacy, L.L.C. PastSince Nov 29, 2020 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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606348800000",
    "number": "1568066843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 WARWICK AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028882601",
            "telephone_number": "401-467-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 WARWICK AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028882601",
            "telephone_number": "401-467-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "JASON",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-26",
        "last_updated": "2020-11-26",
        "certification_date": "2020-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "RI",
            "license": "06057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "other",
            "affiliation": "N",
            "address_1": "767 Warwick Ave",
            "city": "Warwick",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028882601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.

Verify at the official NPI Registry.