Individual provider Active NPI

Jessica Monica Pitcairn, RPH

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Bronx, NY
National Provider Identifier
1548879463
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
036966 Issued in NY
Practice address
1650 Grand Concourse
Bronx, NY 10457-7606
Phone
(718) 518-5020
Fax
(718) 518-5298
NPI assigned
Jul 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 036966 NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Bronx, NY 10457-7606

Mailing address

482 N Long Beach Ave
Freeport, NY 11520-1114
Phone (516) 632-5494

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL mail Direct

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
036966NYMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1548879463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 N LONG BEACH AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201114",
            "telephone_number": "516-632-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-518-5020",
            "fax_number": "718-518-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITCAIRN",
        "first_name": "JESSICA",
        "middle_name": "MONICA",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NY",
            "license": "036966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mail",
            "affiliation": "N",
            "endpointDescription": "mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1650 Grand Concourse",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104577606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.