Jacob Thomas Cannestra, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

22272-40 Issued in WI

Practice address

55 W Pioneer Rd
Fond Du Lac, WI 54935-6151

Phone

(920) 923-7780

NPI assigned

Aug 7, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

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 and National Provider Directory roles.

• Roundys Supermarkets Inc

  • Community/Retail Pharmacy
  • Marshfield, WI
  • NPI 1013484997
  NPD (past)
• Roundys Supermarkets Inc

  • Community/Retail Pharmacy
  • Fond Du Lac, WI
  • NPI 1972796340
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781308800000",
    "number": "1467134635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 LAMPERT ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549015303",
            "telephone_number": "414-581-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W PIONEER RD",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549356151",
            "telephone_number": "920-923-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNESTRA",
        "first_name": "JACOB",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-07",
        "last_updated": "2026-06-13",
        "certification_date": "2026-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WI",
            "license": "22272-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jammi G Cairns, NP
• Katie Calmes
• Christina A Calvello, MD
• Scott A Calvert, APNP
• Tabitha Campagna
• Gilberto Cantu, CRNA
• Kelley Cantu, LMT
• Ann M Cappellari, M.D.
• William Alan Caputo, DMD
• Lisa Carlson-Bebow

• All providers in Fond Du Lac, WI
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2026; 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.