Individual provider Active NPI

Jillian B. Grogan, PHARMD

  • Pharmacist
  • Middle Village, NY
National Provider Identifier
1366846768
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
059968 Issued in NY
Practice address
8002 Eliot Ave
Middle Village, NY 11379-1409
Phone
(718) 429-6611
NPI assigned
Oct 14, 2014
Last updated
Oct 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 059968 NY Primary

Addresses

Primary practice location

8002 Eliot Ave
Middle Village, NY 11379-1409

Mailing address

6149 80TH St
Middle Village, NY 11379-1320

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

State licenses

LicenseStateTypeSpecialty
059968NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Somma Pharmaceutical Co LTD 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1366846768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6149 80TH ST",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113791320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8002 ELIOT AVE",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113791409",
            "telephone_number": "718-429-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROGAN",
        "first_name": "JILLIAN",
        "middle_name": "B.",
        "name_prefix": "Ms.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "059968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.