Individual provider Active NPI

Jessica Marie Wayne

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Pittsburgh, PA
National Provider Identifier
1366119745
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
RP455929 Issued in PA
Practice address
1010 Delafield Rd
Pittsburgh, PA 15215-1802
Phone
(412) 822-2222
NPI assigned
Aug 24, 2021
Last updated
Nov 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP455929 PA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RP455929 PA Primary

Addresses

Primary practice location

1010 Delafield Rd
Pittsburgh, PA 15215-1802

Mailing address

3001 McKnight East Dr Apt 207
Pittsburgh, PA 15237-6401
Phone (304) 374-5559

Other practice location 1

4800 Friendship Ave
Pittsburgh, PA 15224-1722
Phone (412) 605-6389

Other practice location 2

4815 Liberty Ave
Pittsburgh, PA 15224-2156
Phone (412) 578-4677

Other identifiers 1

IdentifierTypeStateIssuer
RP455929OtherPAPENNSYLVANIA STATE BOARD OF PHARMACY

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
RP455929PAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1366119745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 MCKNIGHT EAST DR APT 207",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152376401",
            "telephone_number": "304-374-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 DELAFIELD RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152151802",
            "telephone_number": "412-822-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Friendship Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152241722",
            "country_code": "US",
            "telephone_number": "412-605-6389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4815 Liberty Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152242156",
            "country_code": "US",
            "telephone_number": "412-578-4677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAYNE",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP455929",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "PA",
            "license": "RP455929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA STATE BOARD OF PHARMACY",
            "identifier": "RP455929",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.