Active NPI
John G Medeiros, RPH
- Pharmacist
- Crawfordville, FL
National Provider Identifier
1679855779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS 40809
- Practice address
- 2580 Crawfordville Hwy
Crawfordville, FL 32327-2174 - Phone
- (850) 926-2754
- NPI assigned
- Sep 14, 2011
- Sex
- Male
- 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 | PS 40809 | FL | Primary |
Addresses
Primary practice location
2580 Crawfordville Hwy
Crawfordville, FL 32327-2174
Mailing address
144 Shadow Bay Dr
Eastpoint, FL 32328-3374
Phone (404) 402-7125
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS 40809 | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315958400000",
"number": "1679855779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 SHADOW BAY DR",
"city": "EASTPOINT",
"state": "FL",
"postal_code": "323283374",
"telephone_number": "404-402-7125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2580 CRAWFORDVILLE HWY",
"city": "CRAWFORDVILLE",
"state": "FL",
"postal_code": "323272174",
"telephone_number": "850-926-2754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDEIROS",
"first_name": "JOHN",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-14",
"last_updated": "2011-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS 40809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crawfordville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.