Individual provider Active NPI

Anthony Knight

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1780312918
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS64619 Issued in FL
Practice address
12620 Beach Blvd Ste 12
Jacksonville, FL 32246-7130
Phone
(904) 564-3586
NPI assigned
Aug 15, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X RPH034315 GA
Pharmacist 183500000X PS64619 FL Primary

Addresses

Primary practice location

12620 Beach Blvd Ste 12
Jacksonville, FL 32246-7130

Mailing address

12620 Beach Blvd Ste 12
Jacksonville, FL 32246-7130
Phone (904) 564-3586

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

State licenses

LicenseStateTypeSpecialty
PS64619FLMDPharmacist
RPH034315GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets Inc PastSince Nov 24, 2024 Accepting new patients
Publix Super Markets Inc PastSince Aug 1, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1780312918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12620 BEACH BLVD STE 12",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467130",
            "telephone_number": "904-564-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12620 BEACH BLVD STE 12",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467130",
            "telephone_number": "904-564-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-15",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH034315",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS64619",
            "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 Nov 18, 2024; 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.