Active NPI
Jennifer Walters, PHARM.D.
- Pharmacist
- Troy, MI
National Provider Identifier
1013127380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302028432
- Practice address
- 100 W Big Beaver Rd
Suite 600
Troy, MI 48084-5206 - Phone
- (248) 925-1790
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 5302028432 | MI | Primary |
Addresses
Primary practice location
100 W Big Beaver Rd
Suite 600
Troy, MI 48084-5206
Mailing address
84 Melanie LN
Troy, MI 48098-1707
Phone (248) 561-1168
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302028432 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013127380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 MELANIE LN",
"city": "TROY",
"state": "MI",
"postal_code": "480981707",
"telephone_number": "248-561-1168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W BIG BEAVER RD",
"address_2": "SUITE 600",
"city": "TROY",
"state": "MI",
"postal_code": "480845206",
"telephone_number": "248-925-1790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302028432",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
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.