Individual provider Active NPI

Julia Scrivener

  • Pharmacist
  • Fort Myers, FL
National Provider Identifier
1790349645
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS56408 Issued in FL
Practice address
15880 San Carlos Blvd
Fort Myers, FL 33908-3383
Phone
(239) 265-9003
NPI assigned
Apr 25, 2019
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28458 NC
Pharmacist 183500000X PS56408 FL Primary

Addresses

Primary practice location

15880 San Carlos Blvd
Fort Myers, FL 33908-3383

Mailing address

3500 Wake Forest Rd
Raleigh, NC 27609-7307

Other practice location 1

3500 Wake Forest Rd
Raleigh, NC 27609-7307
Phone (919) 855-5694

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
PS56408FLMDPharmacist
28458NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1790349645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 WAKE FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15880 SAN CARLOS BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083383",
            "telephone_number": "239-265-9003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Wake Forest Rd",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276097307",
            "country_code": "US",
            "telephone_number": "919-855-5694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCRIVENER",
        "first_name": "JULIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "28458",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS56408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.