Individual provider Active NPI

Jennifer Krivonak, PHARMD, RPH,MSPS,BS

  • Pharmacist
  • Cleveland, OH
National Provider Identifier
1366914640
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03331264 Issued in OH
Practice address
3402 Clark Ave
Cleveland, OH 44109-1136
Phone
(216) 961-9414
NPI assigned
Dec 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03331264 OH Primary

Addresses

Primary practice location

3402 Clark Ave
Cleveland, OH 44109-1136

Mailing address

10275 S Red Oak
North Royalton, OH 44133-3382
Phone (330) 559-9494

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
Bachelor of Science, Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
03331264OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Ohio Inc Past Accepting new patients
Rite Aid Pharmacy Pharmacist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1366914640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10275 S RED OAK",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441333382",
            "telephone_number": "330-559-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 CLARK AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091136",
            "telephone_number": "216-961-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIVONAK",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH,MSPS,BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03331264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.