Individual provider Active NPI

Jennifer Michelle Kostus, PHARMD

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1255524187
Registry record updated Aug 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
015182 Issued in AZ
Practice address
3131 W Thunderbird Rd
Phoenix, AZ 85053
Phone
(602) 971-7482
NPI assigned
Aug 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 015182 AZ Primary

Addresses

Primary practice location

3131 W Thunderbird Rd
Phoenix, AZ 85053

Mailing address

3131 W Thunderbird Rd
Phoenix, AZ 85032
Phone (602) 971-7482

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
015182AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187827200000",
    "number": "1255524187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 W THUNDERBIRD RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85032",
            "telephone_number": "602-971-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 W THUNDERBIRD RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85053",
            "telephone_number": "602-971-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTUS",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2007-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "015182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; 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.