Matthew Hodge, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS47011 Issued in FL

Practice address

4255 W New Haven Ave
Melbourne, FL 32904-3317

Phone

(321) 768-0438

Fax

(321) 768-8084

NPI assigned

Nov 16, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1750983680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 W NEW HAVEN AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329043317",
            "telephone_number": "321-768-0438",
            "fax_number": "321-768-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 W NEW HAVEN AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329043317",
            "telephone_number": "321-768-0438",
            "fax_number": "321-768-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS47011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE #",
            "identifier": "PS47011",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mchodge.s08141.us@samsclub.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4255 W New Haven Ave",
            "city": "Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329043317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wendy Leonard Hixon, LMHC
• Kaukwok Frederick Ho, MD
• Steven Ho, MD
• Ann B. Hodge, LMHC
• Empress Upendi Hodge
• Sarah Hodge, PA
• Veronica Conchester Hodges-Francis
• Casey Hodgin, RDN/LDN
• Eric W. Hodgson, D.D.S.
• Kayla Hofacker

• Pharmacist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.