Active NPI
Havnicca Welcome
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1972635969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS30422
- Practice address
- 10915 Baymeadows Rd
Jacksonville, FL 32256-9130 - Phone
- (904) 421-0633
- Fax
- (904) 421-6190
- NPI assigned
- Mar 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS30422 | FL | Primary |
Addresses
Primary practice location
10915 Baymeadows Rd
Jacksonville, FL 32256-9130
Mailing address
11092 Turnbridge Dr
Jacksonville, FL 32256-2328
Phone (904) 646-1602
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS30422 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972635969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11092 TURNBRIDGE DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322562328",
"telephone_number": "904-646-1602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10915 BAYMEADOWS RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322569130",
"telephone_number": "904-421-0633",
"fax_number": "904-421-6190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELCOME",
"first_name": "HAVNICCA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS30422",
"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 Jul 8, 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.