Individual provider Active NPI

Randy Samson Nemecek, PHARMD

  • Pharmacist
  • Tampa, FL
National Provider Identifier
1861884702
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS46861 Issued in FL
Practice address
19315 Yellow Clover Dr
Tampa, FL 33647-3669
Phone
(813) 295-3290
NPI assigned
Mar 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 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 PS46861 FL Primary

Addresses

Primary practice location

19315 Yellow Clover Dr
Tampa, FL 33647-3669

Mailing address

19315 Yellow Clover Dr
Tampa, FL 33647-3669
Phone (813) 295-3290

Other identifiers 1

IdentifierTypeStateIssuer
PS46861OtherFLPHARMACIST LICENSE

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
PS46861FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1861884702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19315 YELLOW CLOVER DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473669",
            "telephone_number": "813-295-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19315 YELLOW CLOVER DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473669",
            "telephone_number": "813-295-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMECEK",
        "first_name": "RANDY",
        "middle_name": "SAMSON",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS46861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PS46861",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.