Individual provider Active NPI

Gregory Bardwell, PHARMD

  • Pharmacist
  • Oviedo, FL
National Provider Identifier
1821493958
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS42339 Issued in FL
Practice address
489 Carolyn Dr
Oviedo, FL 32765-9750
Phone
(352) 408-5559
NPI assigned
Oct 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS42339 FL Primary

Addresses

Primary practice location

489 Carolyn Dr
Oviedo, FL 32765-9750

Mailing address

489 Carolyn Dr
Oviedo, FL 32765-9750
Phone (352) 408-5559

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS42339FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1821493958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 CAROLYN DR",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327659750",
            "telephone_number": "352-408-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 CAROLYN DR",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327659750",
            "telephone_number": "352-408-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDWELL",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS42339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.