Individual provider Active NPI

Jacob Wieland, PHARMD

  • Pharmacist
  • Maysville, KY
National Provider Identifier
1396432597
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
022770 Issued in KY
Practice address
381 Market Square Dr
Maysville, KY 41056-8721
Phone
(606) 956-3160
NPI assigned
Apr 19, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 022770 KY Primary

Addresses

Primary practice location

381 Market Square Dr
Maysville, KY 41056-8721

Mailing address

381 Market Square Dr
Maysville, KY 41056-8721

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
022770KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1396432597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 MARKET SQUARE DR",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410568721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 MARKET SQUARE DR",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410568721",
            "telephone_number": "606-956-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIELAND",
        "first_name": "JACOB",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "022770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maysville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.