Individual provider Active NPI

Dennis Micheal Scarbrough, R PH

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1861560674
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH0012202 Issued in FL
Practice address
7900 103Rd St
Suite 14
Jacksonville, FL 32210-6681
Phone
(904) 772-8998
Fax
(904) 772-1979
NPI assigned
Dec 1, 2006
Last updated
Oct 19, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH0012202 FL Primary
Pharmacist 183500000X PS0014929 FL

Addresses

Primary practice location

7900 103Rd St
Suite 14
Jacksonville, FL 32210-6681

Mailing address

7900 103Rd St
Suite 14
Jacksonville, FL 32210-6681
Phone (904) 772-8998

Other identifiers 1

IdentifierTypeStateIssuer
1069144OtherFLNABP

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH0012202FLMDPharmacist
PS0014929FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis Scarbrough 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1861560674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 103RD ST",
            "address_2": "SUITE 14",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322106681",
            "telephone_number": "904-772-8998",
            "fax_number": "904-772-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 103RD ST",
            "address_2": "SUITE 14",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322106681",
            "telephone_number": "904-772-8998",
            "fax_number": "904-772-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARBROUGH",
        "first_name": "DENNIS",
        "middle_name": "MICHEAL",
        "name_prefix": "Mr.",
        "credential": "R PH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PH0012202",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS0014929",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1069144",
            "state": "FL"
        }
    ],
    "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 Oct 19, 2007; 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.