Individual provider Active NPI

Rebecca Blue O'Connell, PHARMD

  • Pharmacist
  • Lake City, FL
National Provider Identifier
1902385529
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS58191 Issued in FL
Practice address
255 NW Commons Loop
Lake City, FL 32055-7700
Phone
(386) 719-5451
Fax
(386) 719-5456
NPI assigned
Aug 14, 2018
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS58191 FL Primary

Addresses

Primary practice location

255 NW Commons Loop
Lake City, FL 32055-7700

Mailing address

7839 SW 85TH Ter
Gainesville, FL 32608-5791
Phone (305) 393-9495

Other identifiers 1

IdentifierTypeStateIssuer
PS58191OtherFLSTATE LICENSE

Other names 1

  • Rebecca Blue Basler Former name

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
PS58191FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets Inc PastSince Jun 25, 2023 Accepting new patients
Publix Super Markets Inc Past Accepting new patients
Publix Super Markets Inc PastSince Jun 25, 2023 Accepting new patients

Organizations & group practices 3

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": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1902385529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7839 SW 85TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326085791",
            "telephone_number": "305-393-9495",
            "fax_number": "386-719-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 NW COMMONS LOOP",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320557700",
            "telephone_number": "386-719-5451",
            "fax_number": "386-719-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "REBECCA",
        "middle_name": "BLUE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS58191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PS58191",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BASLER",
            "middle_name": "BLUE",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.