Individual provider Active NPI

Jacqueline Marie Roh, RPH, BCPS

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Greensboro, NC
National Provider Identifier
1104208941
Registry record updated Jun 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
06975 Issued in NC
Practice address
1200 N Elm St
Greensboro, NC 27401-1004
Phone
(336) 832-8108
Fax
(336) 832-7198
NPI assigned
Jun 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 06975 NC Primary

Addresses

Primary practice location

1200 N Elm St
Greensboro, NC 27401-1004

Mailing address

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-8108

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
06975NCMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1435449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435449600000",
    "number": "1104208941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011004",
            "telephone_number": "336-832-8108",
            "fax_number": "336-832-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011004",
            "telephone_number": "336-832-8108",
            "fax_number": "336-832-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROH",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "RPH, BCPS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-28",
        "last_updated": "2015-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NC",
            "license": "06975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.