Individual provider Active NPI

Jennifer D. Goldman, PHARM.D., CDE

  • Pharmacotherapy Pharmacist
  • Peabody, MA
National Provider Identifier
1396747192
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
20983 Issued in MA
Practice address
2 1St Ave
Well Life
Peabody, MA 01960-4959
Phone
(978) 740-2300
Fax
(978) 744-5148
NPI assigned
Aug 11, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 20983 MA Primary

Addresses

Primary practice location

2 1St Ave
Well Life
Peabody, MA 01960-4959

Mailing address

179 Longwood Ave
Boston, MA 02115-5804
Phone (617) 732-2917

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
20983MAMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
McPhs University Past Accepting new patients
Forsyth Hygiene Program 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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1396747192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155804",
            "telephone_number": "617-732-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 1ST AVE",
            "address_2": "WELL LIFE",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019604959",
            "telephone_number": "978-740-2300",
            "fax_number": "978-744-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "JENNIFER",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MA",
            "license": "20983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.