Active NPI
Alexis Jakuszewski
- Pharmacist
- Kayenta, AZ
National Provider Identifier
1245078344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051305395
- Practice address
- 394.3, US-160
Kayenta, AZ 86033 - Phone
- (928) 697-5099
- NPI assigned
- Jul 15, 2024
- Last updated
- Jul 15, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051305395 | IL | Primary |
Addresses
Primary practice location
394.3, US-160
Kayenta, AZ 86033
Mailing address
1770 Mustang CT
Wheaton, IL 60189-8483
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 |
|---|---|---|---|
| 051305395 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1245078344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1770 MUSTANG CT",
"city": "WHEATON",
"state": "IL",
"postal_code": "601898483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "394.3, US-160",
"city": "KAYENTA",
"state": "AZ",
"postal_code": "86033",
"telephone_number": "928-697-5099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAKUSZEWSKI",
"first_name": "ALEXIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-15",
"last_updated": "2024-07-15",
"certification_date": "2024-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051305395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kayenta, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.