NPIMap

Individual provider Active NPI

Mark Jobst, RPH

  • Pharmacist
  • Earlham, IA
National Provider Identifier
1154962330
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14772 Issued in IA
Practice address
115 N Chestnut Ave
PO BX 8
Earlham, IA 50072
Phone
(515) 758-2174
Fax
(515) 758-2188
NPI assigned
Sep 30, 2019
Last updated
Sep 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 14772 IA Primary

Addresses

Primary practice location

115 N Chestnut Ave
PO BX 8
Earlham, IA 50072

Mailing address

115 N Chestnut Ave
PO BX 8
Earlham, IA 50072
Phone (515) 758-2174

Other identifiers 1

IdentifierTypeStateIssuer
14772OtherIASTATE PHAMACY LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL montrossearlham@aol.com

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
14772IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Montross Pharmacy,Inc CurrentSince Dec 15, 2024 Accepting new patients
Montross Pharmacy Inc PastSince Oct 6, 2019 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, 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": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1154962330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N CHESTNUT AVE",
            "address_2": "PO BX 8",
            "city": "EARLHAM",
            "state": "IA",
            "postal_code": "50072",
            "telephone_number": "515-758-2174",
            "fax_number": "515-758-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N CHESTNUT AVE",
            "address_2": "PO BX 8",
            "city": "EARLHAM",
            "state": "IA",
            "postal_code": "50072",
            "telephone_number": "515-758-2174",
            "fax_number": "515-758-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOBST",
        "first_name": "MARK",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "14772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHAMACY LICENSE",
            "identifier": "14772",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "montrossearlham@aol.com",
            "affiliation": "N",
            "address_1": "115 n chestnut ave",
            "address_2": "po bx 8",
            "city": "earlham",
            "state": "IA",
            "country_code": "US",
            "postal_code": "50072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Earlham, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.