Individual provider Active NPI

Stephen L Jette

  • Pharmacist
  • Albany, NY
National Provider Identifier
1023330255
Registry record updated Feb 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
038066 Issued in NY
Practice address
16 Walker Way
Albany, NY 12205-4995
Phone
(518) 452-7795
NPI assigned
Feb 15, 2010
Last updated
Feb 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 038066 NY Primary

Addresses

Primary practice location

16 Walker Way
Albany, NY 12205-4995

Mailing address

16 Walker Way
Albany, NY 12205-4995
Phone (518) 452-7795

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
038066NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1266192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266192000000",
    "number": "1023330255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WALKER WAY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122054995",
            "telephone_number": "518-452-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WALKER WAY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122054995",
            "telephone_number": "518-452-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETTE",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-15",
        "last_updated": "2010-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "038066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2010; 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.