Individual provider Active NPI

Chot Van, PHARM.D.

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1689273229
Registry record updated Oct 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS59466 Issued in FL
Practice address
12777 Atlantic Blvd
Jacksonville, FL 32225-7120
Phone
(904) 221-9918
NPI assigned
Oct 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS59466 FL Primary

Addresses

Primary practice location

12777 Atlantic Blvd
Jacksonville, FL 32225-7120

Mailing address

4308 Boat Club Dr
Jacksonville, FL 32277-1202

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
PS59466FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603497600000",
    "number": "1689273229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 BOAT CLUB DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322771202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12777 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322257120",
            "telephone_number": "904-221-9918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "CHOT",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-24",
        "last_updated": "2020-10-24",
        "certification_date": "2020-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS59466",
            "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 Oct 24, 2020; 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.