Individual provider Active NPI

Brandon Panichello, PHARM.D.

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1578238671
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS62922 Issued in FL
Practice address
7117 Merrill Rd
Jacksonville, FL 32277-2620
Phone
(904) 744-8172
NPI assigned
Aug 11, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS62922 FL Primary

Addresses

Primary practice location

7117 Merrill Rd
Jacksonville, FL 32277-2620

Mailing address

6306 Mercer Cir E
Jacksonville, FL 32217-2415
Phone (904) 673-0986

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
PS62922FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets Inc PastSince Aug 15, 2021 Accepting new patients
Publix Super Markets Inc PastSince Aug 15, 2021 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": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1578238671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6306 MERCER CIR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172415",
            "telephone_number": "904-673-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 MERRILL RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772620",
            "telephone_number": "904-744-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANICHELLO",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS62922",
            "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 Aug 11, 2021; 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.