Individual provider Active NPI

Alexander Michael Jagoditz, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Cincinnati, OH
National Provider Identifier
1073145041
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
3334761 Issued in OH
Practice address
6165 Glenway Ave
Cincinnati, OH 45211-6338
Phone
(513) 719-2420
NPI assigned
Feb 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 017751 KY
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 3334761 OH Primary

Addresses

Primary practice location

6165 Glenway Ave
Cincinnati, OH 45211-6338

Mailing address

6165 Glenway Ave
Cincinnati, OH 45211-6338

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
017751KYMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
3334761OHMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1073145041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6165 GLENWAY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452116338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6165 GLENWAY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452116338",
            "telephone_number": "513-719-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGODITZ",
        "first_name": "ALEXANDER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "KY",
            "license": "017751",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OH",
            "license": "3334761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.