Individual provider Active NPI

Jacqueline Dubois Diaz

  • Pharmacist
  • Brentwood, TN
National Provider Identifier
1801267448
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
39412 Issued in TN
Practice address
1003 Brentwood PT
Brentwood, TN 37027-7966
Phone
(321) 720-5710
NPI assigned
Oct 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 39412 TN Primary

Addresses

Primary practice location

1003 Brentwood PT
Brentwood, TN 37027-7966

Mailing address

8105 Moores LN
Brentwood, TN 37027-8020

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
39412TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1801267448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8105 MOORES LN",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370278020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 BRENTWOOD PT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277966",
            "telephone_number": "321-720-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JACQUELINE",
        "middle_name": "DUBOIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "39412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.