Individual provider Active NPI

Jared Grubbs, PHARMD

  • Pharmacist
  • Indianapolis, IN
National Provider Identifier
1023622552
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26025011A Issued in IN
Practice address
4628 E County Line Rd
Indianapolis, IN 46237-9105
Phone
(317) 360-7086
NPI assigned
Sep 2, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 26025011A IN Primary

Addresses

Primary practice location

4628 E County Line Rd
Indianapolis, IN 46237-9105

Mailing address

5346 Havenridge Pass
Greenwood, IN 46143-6205

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

LicenseStateTypeSpecialty
26025011AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1023622552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5346 HAVENRIDGE PASS",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4628 E COUNTY LINE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462379105",
            "telephone_number": "317-360-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBBS",
        "first_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26025011A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.