Active NPI
Wendy Hickman
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1669753026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 34382
- Practice address
- 4715 Hodges Blvd
Jacksonville, FL 32224-2216 - Phone
- (904) 992-4643
- Fax
- (904) 992-6561
- NPI assigned
- Aug 30, 2011
- Sex
- Female
- 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 | 34382 | FL | Primary |
Addresses
Primary practice location
4715 Hodges Blvd
Jacksonville, FL 32224-2216
Mailing address
4715 Hodges Blvd
Jacksonville, FL 32224-2216
Phone (904) 992-4643
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34382 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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": "1314662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314662400000",
"number": "1669753026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4715 HODGES BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322242216",
"telephone_number": "904-992-4643",
"fax_number": "904-992-6561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4715 HODGES BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322242216",
"telephone_number": "904-992-4643",
"fax_number": "904-992-6561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "WENDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-30",
"last_updated": "2011-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "34382",
"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 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.