Active NPI
Jason Lepore
- Pharmacist
- Grand Haven, MI
National Provider Identifier
1063122596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302414766
- Practice address
- 1045 Robbins Rd
Grand Haven, MI 49417-2646 - Phone
- (616) 844-0367
- NPI assigned
- Nov 23, 2022
- Last updated
- Oct 22, 2023
- Sex
- Male
- 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 | 5302414766 | MI | Primary |
Addresses
Primary practice location
1045 Robbins Rd
Grand Haven, MI 49417-2646
Mailing address
16972 Tysman Way Apt 301
Grand Haven, MI 49417-8070
Phone (705) 943-2361
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302414766 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1045 Robbins Rd
Grand Haven, MI 49417
Phone (616) 844-0367
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697932800000",
"number": "1063122596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16972 TYSMAN WAY APT 301",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494178070",
"telephone_number": "705-943-2361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 ROBBINS RD",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494172646",
"telephone_number": "616-844-0367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEPORE",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-23",
"last_updated": "2023-10-22",
"certification_date": "2023-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302414766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Haven, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.