Jatea Monet Maddox, PHARM. D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS46479 Issued in FL

Practice address

2575 Enterprise Rd
Target Pharmacy Store Number (T-0874)
Orange City, FL 32763-7960

Phone

(386) 774-6477

Fax

(386) 774-6477

NPI assigned

Jul 5, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1871880385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 ENTERPRISE RD",
            "address_2": "TARGET PHARMACY STORE NUMBER (T-0874)",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637960",
            "telephone_number": "386-774-6477",
            "fax_number": "386-774-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 ENTERPRISE RD",
            "address_2": "TARGET PHARMACY STORE NUMBER (T-0874)",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637960",
            "telephone_number": "386-774-6477",
            "fax_number": "386-774-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "JATEA",
        "middle_name": "MONET",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS46479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Orange City, FL
• Providers in Orange City, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.