Active NPI
Jean M Walters, RPH
- Pharmacist
- South Yarmouth, MA
National Provider Identifier
1033493416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH16857
- Practice address
- 1041 Route 28
South Yarmouth, MA 02664-4115 - Phone
- (508) 394-1325
- Fax
- (508) 760-9717
- NPI assigned
- Oct 4, 2011
- 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 | PH16857 | MA | Primary |
Addresses
Primary practice location
1041 Route 28
South Yarmouth, MA 02664-4115
Mailing address
27 Colonial Way
Falmouth, MA 02540-4315
Phone (508) 540-6208
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PH16857 | Other | MA | BOARD OF PHARMACY PHARMACIST REGISTRATION |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH16857 | MA | 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": "1317686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317686400000",
"number": "1033493416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 COLONIAL WAY",
"city": "FALMOUTH",
"state": "MA",
"postal_code": "025404315",
"telephone_number": "508-540-6208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1041 ROUTE 28",
"city": "SOUTH YARMOUTH",
"state": "MA",
"postal_code": "026644115",
"telephone_number": "508-394-1325",
"fax_number": "508-760-9717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "JEAN",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-04",
"last_updated": "2011-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH16857",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY PHARMACIST REGISTRATION",
"identifier": "PH16857",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Yarmouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.