Individual provider Active NPI

Jesse Robert Rickelman, PHARMD.

  • Nuclear Pharmacist
  • Highland, IN
National Provider Identifier
1154854289
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear PharmacistTaxonomy code 1835N0905X
License
26023662A Issued in IN
Practice address
2715 Main St
Highland, IN 46322-3636
Phone
(219) 924-3795
NPI assigned
Apr 5, 2017
Last updated
Apr 5, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Pharmacist 1835N0905X 5637 SD
Nuclear Pharmacist 1835N0905X 26023662A IN Primary

Addresses

Primary practice location

2715 Main St
Highland, IN 46322-3636

Mailing address

2708 43Rd St
Highland, IN 46322-3062
Phone (630) 651-1952

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
26023662AINMDNuclear Pharmacist
5637SDMDNuclear Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cardinal Health 414, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1154854289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 43RD ST",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463223062",
            "telephone_number": "630-651-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 MAIN ST",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463223636",
            "telephone_number": "219-924-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKELMAN",
        "first_name": "JESSE",
        "middle_name": "ROBERT",
        "credential": "PHARMD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835N0905X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nuclear",
            "state": "SD",
            "license": "5637",
            "primary": false
        },
        {
            "code": "1835N0905X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nuclear",
            "state": "IN",
            "license": "26023662A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.