Jessica Lynn Bogucki

Primary specialty

PharmacistTaxonomy code 183500000X

License

15563 Issued in AL

Practice address

5324 Bristolwood Cir
Northport, AL 35475-5938

Phone

(205) 792-7494

NPI assigned

Oct 22, 2020

Last updated

Oct 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1225637929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13620 HIGHWAY 43 N",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354754580",
            "telephone_number": "205-333-0678",
            "fax_number": "205-333-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5324 BRISTOLWOOD CIR",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354755938",
            "telephone_number": "205-792-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGUCKI",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "15563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Northport, AL
• Providers in Northport, AL by specialty
• Pharmacist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.