Active NPI
Jonathan Freer, PHARMD
- Pharmacist
- Wenonah, NJ
National Provider Identifier
1114688694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03908400
- Practice address
- 1098 Mantua Pike
Wenonah, NJ 08090 - Phone
- (856) 464-1077
- NPI assigned
- Jan 6, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH032746 | GA | |
| Pharmacist | 183500000X | 28RI03908400 | NJ | Primary |
Addresses
Primary practice location
1098 Mantua Pike
Wenonah, NJ 08090
Mailing address
19 Boxwood CT
Mantua, NJ 08051-1394
Other practice location 1
695 W Crossville Rd
Roswell, GA 30075-2500
Phone (770) 650-6692
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH032746 | GA | MD | Pharmacist |
| 28RI03908400 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Jersey CVS Pharmacy LLC | Past | Accepting new patients | |
| New Jersey CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706918400000",
"number": "1114688694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 BOXWOOD CT",
"city": "MANTUA",
"state": "NJ",
"postal_code": "080511394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1098 MANTUA PIKE",
"city": "WENONAH",
"state": "NJ",
"postal_code": "08090",
"telephone_number": "856-464-1077"
}
],
"practiceLocations": [
{
"address_1": "695 W Crossville Rd",
"address_purpose": "LOCATION",
"city": "Roswell",
"state": "GA",
"postal_code": "300752500",
"country_code": "US",
"telephone_number": "770-650-6692",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FREER",
"first_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-06",
"last_updated": "2024-02-03",
"certification_date": "2024-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH032746",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03908400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wenonah, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.