Active NPI
Jessica Stafford, PHARMD
- Pharmacist
- Kentwood, MI
National Provider Identifier
1023427010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302039410
- Practice address
- 2425 44TH St SE
Kentwood, MI 49512-3878 - Phone
- (616) 455-5151
- NPI assigned
- Aug 5, 2014
- 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 | 5302039410 | MI | Primary |
Addresses
Primary practice location
2425 44TH St SE
Kentwood, MI 49512-3878
Mailing address
2425 44TH St SE
Kentwood, MI 49512-3878
Phone (616) 455-5151
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 |
|---|---|---|---|
| 5302039410 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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": "1407196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407196800000",
"number": "1023427010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 44TH ST SE",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495123878",
"telephone_number": "616-455-5151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 44TH ST SE",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495123878",
"telephone_number": "616-455-5151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAFFORD",
"first_name": "JESSICA",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-05",
"last_updated": "2014-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302039410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kentwood, MI
- Spectrum Health Primary Care Partners (Corewell Health Medical Group West)
- Spectrum Health Primary Care Partners (Corewell Health Medical Group West)
- Sarah Katherine Spencer
- Jacob Scott Spiess
- John Devlin Sprague, D.O.
- Bambi Stalker, MA
- Shelby Marie Stamann, RBT
- Christine Eg Stancle, CBD, CLC
- Latesha Stanton
- Linda Renea Starks
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.