Individual provider Active NPI

Jacqueline Rudy Thomas, RPH

  • Pharmacist
  • Syracuse, NY
National Provider Identifier
1407031818
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
029321 Issued in NY
Practice address
4751 Onondaga Blvd
Syracuse, NY 13219-3315
Phone
(315) 476-2141
Fax
(315) 475-8632
NPI assigned
Jan 3, 2008
Last updated
Jan 3, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 029321 NY Primary

Addresses

Primary practice location

4751 Onondaga Blvd
Syracuse, NY 13219-3315

Mailing address

4751 Onondaga Blvd
Syracuse, NY 13219-3315
Phone (315) 476-2141

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
029321NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199318400000",
    "number": "1407031818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4751 ONONDAGA BLVD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132193315",
            "telephone_number": "315-476-2141",
            "fax_number": "315-475-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4751 ONONDAGA BLVD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132193315",
            "telephone_number": "315-476-2141",
            "fax_number": "315-475-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JACQUELINE",
        "middle_name": "RUDY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "029321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.