Active NPI
Amy Lynn Jacobs, RPH
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Mount Pleasant, MI
National Provider Identifier
1316172018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 5302028001
- Practice address
- 117 N Mission St
Mount Pleasant, MI 48858-1819 - Phone
- (989) 772-7677
- Fax
- (989) 773-0663
- NPI assigned
- May 25, 2009
- 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 |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 5302028001 | MI | Primary |
Addresses
Primary practice location
117 N Mission St
Mount Pleasant, MI 48858-1819
Mailing address
117 N Mission St
Mount Pleasant, MI 48858-1819
Phone (989) 772-7677
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 |
|---|---|---|---|
| 5302028001 | MI | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Perry Drug Stores Inc and Subsidiaries | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Commerce Township, MI
- NPI 1871602391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243209600000",
"number": "1316172018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 N MISSION ST",
"city": "MOUNT PLEASANT",
"state": "MI",
"postal_code": "488581819",
"telephone_number": "989-772-7677",
"fax_number": "989-773-0663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 N MISSION ST",
"city": "MOUNT PLEASANT",
"state": "MI",
"postal_code": "488581819",
"telephone_number": "989-772-7677",
"fax_number": "989-773-0663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "AMY",
"middle_name": "LYNN",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-25",
"last_updated": "2009-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MI",
"license": "5302028001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.