Individual provider Active NPI

Jordan Fraker, PHARMD

  • Pharmacist
  • Harrisburg, PA
National Provider Identifier
1063188704
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP455884 Issued in PA
Practice address
4299 Union Deposit Rd
Harrisburg, PA 17111-2802
Phone
(717) 564-6750
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP455884 PA Primary

Addresses

Primary practice location

4299 Union Deposit Rd
Harrisburg, PA 17111-2802

Mailing address

1908 Christopher PL
Harrisburg, PA 17110-3574
Phone (717) 307-0161

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
RP455884PAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1063188704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 CHRISTOPHER PL",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171103574",
            "telephone_number": "717-307-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4299 UNION DEPOSIT RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171112802",
            "telephone_number": "717-564-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAKER",
        "first_name": "JORDAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP455884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.