Active NPI
Jam Mia Marcy M Yu
- Student in an Organized Health Care Education/Training Program
- Philadelphia, PA
National Provider Identifier
1174494744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- PI128115
- Practice address
- 808 N 19TH St Apt 308
Philadelphia, PA 19130-2096 - Phone
- (786) 797-6866
- NPI assigned
- Sep 16, 2025
- Sex
- Female
- 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 | PI128115 | PA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | PI128115 | PA | Primary |
Addresses
Primary practice location
808 N 19TH St Apt 308
Philadelphia, PA 19130-2096
Mailing address
808 N 19TH St Apt 308
Philadelphia, PA 19130-2096
Phone (786) 797-6866
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PI128115 | PA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757980800000",
"number": "1174494744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 N 19TH ST APT 308",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191302096",
"telephone_number": "786-797-6866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 N 19TH ST APT 308",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191302096",
"telephone_number": "786-797-6866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YU",
"first_name": "JAM MIA MARCY",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-16",
"last_updated": "2025-09-16",
"certification_date": "2025-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "PI128115",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "PI128115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.