Jean Marie Wallingford, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

15093 Issued in IA

Practice address

1405 S Grand Ave
Charles City, IA 50616-3670

Phone

(641) 228-7940

Fax

(641) 228-7883

NPI assigned

Feb 24, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1306168935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 S GRAND AVE",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506163670",
            "telephone_number": "641-228-7940",
            "fax_number": "641-228-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 S GRAND AVE",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506163670",
            "telephone_number": "641-228-7940",
            "fax_number": "641-228-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLINGFORD",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-24",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "15093",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "12350",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Charles City, IA
• Providers in Charles City, IA by specialty
• Pharmacist in Iowa

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

Verify at the official NPI Registry.