Jeff Longstaff Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

JEFF LONGSTAFF CORPORATION

Doing business as

Medicap Pharmacy

Practice address

405 S Sumner Ave
Creston, IA 50801-3330

Phone

(641) 782-6558

Fax

(641) 782-7346

NPI assigned

Oct 3, 2006

Last updated

Oct 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alex Pettit, PHARMDNPI 1376131805

Title

Pharmacist in Charge

Phone

(641) 782-6558

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Medicap Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in IA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alex Pettit, PHARMD

  • Pharmacist
  • Creston, IA
  • NPI 1376131805
  NPD Authorized official
• Jeffrey Longstaff, RPH

  • Pharmacist
  • Creston, IA
  • NPI 1598357709
  NPD (past)
• Taryn Leigh Nelson, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Creston, IA
  • NPI 1144997834
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1447344858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S SUMNER AVE",
            "city": "CRESTON",
            "state": "IA",
            "postal_code": "508013330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S SUMNER AVE",
            "city": "CRESTON",
            "state": "IA",
            "postal_code": "508013330",
            "telephone_number": "641-782-6558",
            "fax_number": "641-782-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF LONGSTAFF CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "PETTIT",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "641-782-6558",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IA",
            "license": "850",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0201715",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1613478",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicap Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Creston, IA
• Providers in Creston, IA by specialty
• Community/Retail Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.