Individual provider Active NPI

Jenny Marie Hentz, PHARMD

  • Pharmacist
  • Matthews, NC
National Provider Identifier
1053794495
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
25247 Issued in NC
Practice address
15090 Idlewild Rd
Matthews, NC 28104-3653
Phone
(704) 882-4051
NPI assigned
Jul 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 25247 NC Primary

Addresses

Primary practice location

15090 Idlewild Rd
Matthews, NC 28104-3653

Mailing address

15090 Idlewild Rd
Matthews, NC 28104-3653
Phone (704) 882-4051

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
25247NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1053794495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15090 IDLEWILD RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281043653",
            "telephone_number": "704-882-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15090 IDLEWILD RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281043653",
            "telephone_number": "704-882-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENTZ",
        "first_name": "JENNY",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "25247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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.