Individual provider Active NPI

Mandel Jermaine Hearns, PHARM. D

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1851672190
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS33463 Issued in FL
Practice address
9700 Argyle Forest Blvd
Jacksonville, FL 32222-2809
Phone
(904) 778-0871
NPI assigned
Aug 31, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS33463 FL Primary

Addresses

Primary practice location

9700 Argyle Forest Blvd
Jacksonville, FL 32222-2809

Mailing address

9455 Woodleigh Mill Dr
Jacksonville, FL 32244-7918
Phone (904) 778-1750

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
PS33463FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1851672190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9455 WOODLEIGH MILL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322447918",
            "telephone_number": "904-778-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 ARGYLE FOREST BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322222809",
            "telephone_number": "904-778-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARNS",
        "first_name": "MANDEL",
        "middle_name": "JERMAINE",
        "name_prefix": "Mr.",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS33463",
            "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 Aug 31, 2011; 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.