Individual provider Active NPI

Christopher C Greenwell, RPH

  • Pharmacist
  • Titusville, FL
National Provider Identifier
1720170798
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS29672 Issued in FL
Practice address
1535 N Singleton Ave
Winn Dixie Pharmacy
Titusville, FL 32796-1647
Phone
(321) 264-2055
Fax
(321) 267-4845
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS29672 FL Primary

Addresses

Primary practice location

1535 N Singleton Ave
Winn Dixie Pharmacy
Titusville, FL 32796-1647

Mailing address

207 Olmstead Dr
Titusville, FL 32780-5722

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

LicenseStateTypeSpecialty
PS29672FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720170798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 OLMSTEAD DR",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 N SINGLETON AVE",
            "address_2": "WINN DIXIE PHARMACY",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327961647",
            "telephone_number": "321-264-2055",
            "fax_number": "321-267-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWELL",
        "first_name": "CHRISTOPHER",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS29672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.