Individual provider Active NPI

Jennifer Johnson

  • Pharmacist
  • Johnston, IA
National Provider Identifier
1013392877
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
22541 Issued in IA
Practice address
5750 Merle Hay Rd
Johnston, IA 50131-1215
Phone
(515) 270-9212
Fax
(515) 270-0860
NPI assigned
Jul 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 22541 IA Primary

Addresses

Primary practice location

5750 Merle Hay Rd
Johnston, IA 50131-1215

Mailing address

5750 Merle Hay Rd
Johnston, IA 50131-1215
Phone (515) 270-9212

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

LicenseStateTypeSpecialty
22541IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa CVS Pharmacy LLC PastSince Aug 1, 2021 Accepting new patients
Iowa CVS Pharmacy, LLC PastSince Aug 1, 2021 Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1013392877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 MERLE HAY RD",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311215",
            "telephone_number": "515-270-9212",
            "fax_number": "515-270-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 MERLE HAY RD",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311215",
            "telephone_number": "515-270-9212",
            "fax_number": "515-270-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-22",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "22541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.