Individual provider Active NPI

Jonathan A Mordis, PHARM D

  • Pharmacist
  • Coral Springs, FL
National Provider Identifier
1619101359
Registry record updated May 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS39141 Issued in FL
Practice address
12151 NW 57TH St
Coral Springs, FL 33076-3642
Phone
(954) 298-1736
NPI assigned
May 10, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS39141 FL Primary

Addresses

Primary practice location

12151 NW 57TH St
Coral Springs, FL 33076-3642

Mailing address

12151 NW 57TH St
Coral Springs, FL 33076-3642
Phone (954) 298-1736

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
PS39141FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1241913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241913600000",
    "number": "1619101359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12151 NW 57TH ST",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763642",
            "telephone_number": "954-298-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12151 NW 57TH ST",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763642",
            "telephone_number": "954-298-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORDIS",
        "first_name": "JONATHAN",
        "middle_name": "A",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-10",
        "last_updated": "2009-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS39141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2009; 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.