Individual provider Active NPI

Mustapha Jobe

  • Pharmacist
  • Louisville, KY
National Provider Identifier
1275350985
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
024658 Issued in KY
Practice address
1265 Goss Ave
Louisville, KY 40217-2271
Phone
(502) 634-0724
NPI assigned
Sep 24, 2024
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 024658 KY Primary

Addresses

Primary practice location

1265 Goss Ave
Louisville, KY 40217-2271

Mailing address

1265 Goss Ave
Louisville, KY 40217-2271
Phone (502) 634-0724

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

LicenseStateTypeSpecialty
024658KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1275350985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 GOSS AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402172271",
            "telephone_number": "502-634-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 GOSS AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402172271",
            "telephone_number": "502-634-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOBE",
        "first_name": "MUSTAPHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "024658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.

Verify at the official NPI Registry.