Active NPI
Jennifer Grant, RPH
- Geriatric Pharmacist
- Gouverneur, NY
National Provider Identifier
1295058410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Pharmacist
- License
- 20 046773
- Practice address
- 29 East Main Street
Gouverneur, NY 13642 - Phone
- (315) 287-5002
- Fax
- (180) 089-8423
- NPI assigned
- Mar 2, 2010
- Last updated
- Mar 2, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 20 046773 | NY | Primary |
Addresses
Primary practice location
29 East Main Street
Gouverneur, NY 13642
Mailing address
147 Church Street
Hermon, NY 13652
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20 046773 | NY | MD | Geriatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267488000000",
"number": "1295058410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 CHURCH STREET",
"city": "HERMON",
"state": "NY",
"postal_code": "13652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 EAST MAIN STREET",
"city": "GOUVERNEUR",
"state": "NY",
"postal_code": "13642",
"telephone_number": "315-287-5002",
"fax_number": "180-089-8423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "JENNIFER",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-02",
"last_updated": "2010-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "NY",
"license": "20 046773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gouverneur, NY
- Gouverneur Nursing Home Company Inc. (Kinney Nursing Home)
- Gouverneur Pediatrics,PC
- Gouverneur Physical Therapy, PLLC
- Gouverneur Volunteer Rescue Squad Inc
- Gouverneur Volunteer Rescue Squad Inc
- Bruce John Grattan Jr., DO, MS, RD
- James Grenier, PHARM D
- Teah Lee Griffith
- Payam Hadian, MD
- Christina Harman
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.