Peter Wright Jaeger, PHARM.D.

Primary specialty

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

License

2018033923 Issued in MO

Practice address

24760 Hospital Rd
Red Lake, MN 56671

Phone

(218) 679-0169

NPI assigned

Sep 20, 2018

Last updated

May 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cowlitz Indian Tribe

  • General Practice Physician
  • Longview, WA
  • NPI 1851328447
  NPD (past)

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1487138988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9321 ALAMANDER CT APT 201",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339197428",
            "telephone_number": "630-880-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24760 HOSPITAL RD",
            "city": "RED LAKE",
            "state": "MN",
            "postal_code": "56671",
            "telephone_number": "218-679-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAEGER",
        "first_name": "PETER",
        "middle_name": "WRIGHT",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-20",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2018033923",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MO",
            "license": "2018033923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lee Hood
• Roseline Ngozi Ihim, M.D
• Independent School District #38
• Independent School District #38
• Independent School District #38
• Kari Lynn Josefson, DNP, FNP-BC
• Jourdain Perpich Extended Care Center Inc (Jourdain/Perpich Extended Care Center)
• Patrick Ryan Kelly, MSN, APRN, PMHNP-BC
• Andrew S Kingbird, CHW, CASE MANAGER
• Keveon K Kingbird, CHW

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Red Lake, MN
• Providers in Red Lake, MN by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.