Individual provider Active NPI

James Robert Terrell IV, PHARM. D.

  • Pharmacist
  • Callahan, FL
National Provider Identifier
1619137734
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS42680 Issued in FL
Practice address
542325 US Highway 1
Callahan, FL 32011-6496
Phone
(904) 879-4233
Fax
(904) 879-6470
NPI assigned
Jun 12, 2008
Last updated
Jun 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS42680 FL Primary

Addresses

Primary practice location

542325 US Highway 1
Callahan, FL 32011-6496

Mailing address

542325 US Highway 1
Callahan, FL 32011-6496
Phone (904) 879-4233

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
PS42680FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1619137734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542325 US HIGHWAY 1",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320116496",
            "telephone_number": "904-879-4233",
            "fax_number": "904-879-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542325 US HIGHWAY 1",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320116496",
            "telephone_number": "904-879-4233",
            "fax_number": "904-879-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRELL",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS42680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Callahan, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.