Active NPI
De'Netta Denise Harris, RPH
- Pharmacist
- Orange Park, FL
National Provider Identifier
1760105860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS64703
- Practice address
- 630 Blanding Blvd
Orange Park, FL 32073-5007 - Phone
- (904) 272-3750
- NPI assigned
- Sep 22, 2022
- Last updated
- Sep 22, 2022
- 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 | PS64703 | FL | Primary |
Addresses
Primary practice location
630 Blanding Blvd
Orange Park, FL 32073-5007
Mailing address
630 Blanding Blvd
Orange Park, FL 32073-5007
Phone (904) 272-3750
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 |
|---|---|---|---|
| PS64703 | 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": "1663804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663804800000",
"number": "1760105860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 BLANDING BLVD",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320735007",
"telephone_number": "904-272-3750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 BLANDING BLVD",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320735007",
"telephone_number": "904-272-3750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "DE'NETTA",
"middle_name": "DENISE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-22",
"last_updated": "2022-09-22",
"certification_date": "2022-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS64703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange Park, FL
- Julie M Harrington, PA-C
- Harris Wilcox and Donovan PA (Clay Eye Physicians and Surgeons PA/Fleming Island Optical)
- Harris Wilcox and Donovan PA (Clay Eye Physicians and Surgeons)
- Clarence M Harris, MD
- Dawn L Harris, APRN, FNP-C
- Jeffrey M Harris, MD
- Ladaysha Harris
- Suzanne Harris, PTA
- Trent Charles Harrison, PT, DPT
- Brooke Elizabeth Harry
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.