Individual provider Active NPI

Lori R Donnelly, PHARM.D., R.PH.

  • Pharmacist
  • Chardon, OH
National Provider Identifier
1073893764
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03120464 Issued in OH
Practice address
501 Water St
Chardon, OH 44024-1146
Phone
(440) 286-4167
Fax
(440) 285-3141
NPI assigned
Aug 25, 2011
Last updated
Aug 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03120464 OH Primary

Addresses

Primary practice location

501 Water St
Chardon, OH 44024-1146

Mailing address

13370 Walnut Trce
Chardon, OH 44024-9350
Phone (440) 564-9495

Other names 1

  • Dr. Lori R Jacobs Former name

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
03120464OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1073893764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13370 WALNUT TRCE",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440249350",
            "telephone_number": "440-564-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WATER ST",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241146",
            "telephone_number": "440-286-4167",
            "fax_number": "440-285-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "LORI",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-25",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03120464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "JACOBS",
            "middle_name": "R",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chardon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.

Verify at the official NPI Registry.