Justin Elliot Profitt, PHARM. D

Primary specialty

PharmacistTaxonomy code 183500000X

License

2286 Issued in AK

Practice address

1350 S Seward Meridian Pkwy
Wasilla, AK 99654-8332

Phone

(907) 376-9783

NPI assigned

Feb 23, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1992197362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 E MOUNTAIN VILLAGE DR",
            "address_2": "STE B 431",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547373",
            "telephone_number": "907-232-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S SEWARD MERIDIAN PKWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548332",
            "telephone_number": "907-376-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFITT",
        "first_name": "JUSTIN",
        "middle_name": "ELLIOT",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AK",
            "license": "2286",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "7485",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Pharmacist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.