Individual provider Active NPI

Jason Zellers

  • Pharmacist
  • Lansing, MI
National Provider Identifier
1457121956
Registry record updated Nov 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302416935 Issued in MI
Practice address
410 E Jolly Rd
Lansing, MI 48910-6649
Phone
(517) 882-2732
NPI assigned
Jan 5, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pharmacist 183500000X 5302416935 MI Primary

Addresses

Primary practice location

410 E Jolly Rd
Lansing, MI 48910-6649

Mailing address

1004 4 Mile Rd NW Apt 1a
Grand Rapids, MI 49544-1560
Phone (616) 719-9277

Other practice location 1

100 Cherry St SE
Grand Rapids, MI 49503-4526
Phone (616) 965-8206

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

LicenseStateTypeSpecialty
5302416935MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730505600000",
    "number": "1457121956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 4 MILE RD NW APT 1A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495441560",
            "telephone_number": "616-719-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E JOLLY RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106649",
            "telephone_number": "517-882-2732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Cherry St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034526",
            "country_code": "US",
            "telephone_number": "616-965-8206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZELLERS",
        "first_name": "JASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302416935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2024; 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.