Individual provider Active NPI

Jean Paul Gibeault, R.PH, PHARMD

  • Pharmacist
  • Jersey City, NJ
National Provider Identifier
1285051995
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03326600 Issued in NJ
Practice address
165 Erie St
Newport Pharmacy
Jersey City, NJ 07302-1717
Phone
(201) 963-1903
NPI assigned
Mar 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03326600 NJ Primary

Addresses

Primary practice location

165 Erie St
Newport Pharmacy
Jersey City, NJ 07302-1717

Mailing address

165 Erie St
Newport Pharmacy
Jersey City, NJ 07302-1717
Phone (201) 963-1903

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI03326600NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1285051995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 ERIE ST",
            "address_2": "NEWPORT PHARMACY",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073021717",
            "telephone_number": "201-963-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 ERIE ST",
            "address_2": "NEWPORT PHARMACY",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073021717",
            "telephone_number": "201-963-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBEAULT",
        "first_name": "JEAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "R.PH, PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-20",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03326600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.