Active NPI
Jennifer Greenman
- Pharmacist
- Benton Harbor, MI
National Provider Identifier
1417356361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302030754
- Practice address
- 1400 Mall Dr
Benton Harbor, MI 49022-2325 - Phone
- (269) 927-6514
- NPI assigned
- Aug 16, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302030754 | MI | Primary |
Addresses
Primary practice location
1400 Mall Dr
Benton Harbor, MI 49022-2325
Mailing address
3938 Atherton Dr
Coloma, MI 49038-9751
Other names 1
- Jennifer Rockey
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302030754 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408147200000",
"number": "1417356361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3938 ATHERTON DR",
"city": "COLOMA",
"state": "MI",
"postal_code": "490389751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 MALL DR",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490222325",
"telephone_number": "269-927-6514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENMAN",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-16",
"last_updated": "2014-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302030754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "ROCKEY",
"credential": "R.PH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.