Individual provider Active NPI

Jessica Mae Grasham, PHARMD

  • Pharmacist
  • Huntsville, AL
National Provider Identifier
1376825182
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16478 Issued in AL
Practice address
2418 Bell Manor Dr SW
Huntsville, AL 35803-3427
Phone
(256) 783-9469
NPI assigned
Sep 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16478 AL Primary

Addresses

Primary practice location

2418 Bell Manor Dr SW
Huntsville, AL 35803-3427

Mailing address

2418 Bell Manor Dr SW
Huntsville, AL 35803-3427
Phone (256) 783-9469

Other identifiers 1

IdentifierTypeStateIssuer
16478OtherALAL STATE BOARD OF PHARMACY LICENSE

Other names 1

  • Miss Jessica Mae Gresham Former name

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
16478ALMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1376825182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 BELL MANOR DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358033427",
            "telephone_number": "256-783-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 BELL MANOR DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358033427",
            "telephone_number": "256-783-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRASHAM",
        "first_name": "JESSICA",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-16",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "16478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL STATE BOARD OF PHARMACY LICENSE",
            "identifier": "16478",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GRESHAM",
            "middle_name": "MAE",
            "prefix": "MISS",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.