Individual provider Active NPI

William Rudolph Elliott, RPH

Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Jacksonville, FL

National Provider Identifier

1831438795

Registry record updated Mar 18, 2021

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices1
NPI Registry JSON
Other providers in Jacksonville, FL
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License: PS19392 Issued in FL
Practice address: 6331 Eastwood LN
Jacksonville, FL 32211-3918
Phone: (904) 314-4022
NPI assigned: Feb 12, 2013
Sex: Male
Sole proprietor: Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	PS19392	FL
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	1835P0018X	PS19392	FL	Primary

Addresses

Primary practice location

6331 Eastwood LN
Jacksonville, FL 32211-3918

Mailing address

6331 Eastwood LN
Jacksonville, FL 32211-3918
Phone (904) 314-4022

Other identifiers 1

Identifier	Type	State	Issuer
PS19392	Medicaid	FL

Electronic endpoints 17

Type	Endpoint	Use
CONNECT URL	Middleburg	Health Information Exchange (HIE)
CONNECT URL	Jacksonville	Health Information Exchange (HIE)
CONNECT URL	Jacksonville	Health Information Exchange (HIE)
CONNECT URL	Jacksonville	Health Information Exchange (HIE)
CONNECT URL	Jacksonville	Health Information Exchange (HIE)
CONNECT URL	Middleburg	Health Information Exchange (HIE)
CONNECT URL	Jacksonville	Health Information Exchange (HIE)
CONNECT URL	Jacksonville	Health Information Exchange (HIE)
CONNECT URL	Middleburg	Health Information Exchange (HIE)
CONNECT URL	Jacksonville	Health Information Exchange (HIE)
CONNECT URL	Jacksonville	Health Information Exchange (HIE)
CONNECT URL	Jacksonville	Health Information Exchange (HIE)
CONNECT URL	Jacksonville	Health Information Exchange (HIE)
CONNECT URL	Middleburg	Health Information Exchange (HIE)
CONNECT URL	Jacksonville	Health Information Exchange (HIE)
CONNECT URL	Jacksonville	Health Information Exchange (HIE)
CONNECT URL	Jacksonville

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Not enrolled
Credentials: Registered Pharmacist

State licenses

License	State	Type	Specialty
PS19392	FL	MD	Pharmacist

Practice roles

Organization	Specialty	Status	New patients
Home Care Solutions		Past	Accepting new patients

Organizations & group practices 1

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.

Home Care Solutions
- Home Infusion Therapy Pharmacy
- Maitland, FL
- NPI 1528151024
NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1831438795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6331 EASTWOOD LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322113918",
            "telephone_number": "904-314-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6331 EASTWOOD LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322113918",
            "telephone_number": "904-314-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "WILLIAM",
        "middle_name": "RUDOLPH",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-12",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS19392",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS19392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PS19392",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Middleburg",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
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            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "use": "HIE",
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            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
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            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
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            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
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            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
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            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Middleburg",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Middleburg",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
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            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Middleburg",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "address_1": "6331 Eastwood Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322113918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Mar 18, 2021; 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.