Jesse Ryan Alvarado, PHARMD, MBA

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302044722 Issued in MI

Practice address

2900 Burlingame Ave SW
Wyoming, MI 49509-2610

Phone

(616) 538-1490

Fax

(616) 531-8855

NPI assigned

Jun 6, 2017

Last updated

Apr 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration, Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prevos Family Markets LLC

  dba Family Fare Pharmacy

  • Community/Retail Pharmacy
  • Wyoming, MI
  • NPI 1023177029
  NPD (past)
• Prevos Family Markets LLC

  dba Family Fare Pharmacy #1979

  • Community/Retail Pharmacy
  • Battle Creek, MI
  • NPI 1881832830
  NPD (past)

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1457880205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 BURLINGAME AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495092610",
            "telephone_number": "616-538-1490",
            "fax_number": "616-531-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BURLINGAME AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495092610",
            "telephone_number": "616-538-1490",
            "fax_number": "616-531-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVARADO",
        "first_name": "JESSE",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-06",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302044722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1189609",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phyllene Allison
• Michael Alofs
• Mershed Alsamara, MD
• Terese Diane Alsum, AUD
• Kendell Rae Altena, COTA
• Arianna Velazquez Amado
• Amanda Dehaan Counseling, LLC
• Yagin An
• Elizabeth Anastasia, PHD
• Latricia Andersen, PHARM.D.

• Pharmacist in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; 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.