Active NPI
Jacquelyn Mercedes Rossi, PHARMD
- Pharmacist
- Winterville, NC
National Provider Identifier
1558962183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29375
- Practice address
- 3801 S Memorial Dr
Winterville, NC 28590-8618 - Phone
- (252) 917-6865
- NPI assigned
- Nov 2, 2020
- Last updated
- Nov 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS42004 | FL | |
| Pharmacist | 183500000X | 29375 | NC | Primary |
Addresses
Primary practice location
3801 S Memorial Dr
Winterville, NC 28590-8618
Mailing address
8415 SW 107TH Ave Apt 327W
Miami, FL 33173-4369
Phone (786) 251-5360
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS42004 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Treasure Island Pharmacy Care Inc | Current | Accepting new patients | |
| Treasure Island Pharmacy Care Inc | Current | Accepting new patients | |
| Wal-Mart Stores East, LP | Past | Accepting new patients | |
| Wal-Mart Stores East LP | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Community/Retail Pharmacy
- North Bay Village, FL
- NPI 1043513864
-
dba Treasure Island Pharmacy
- Pharmacy
- North Bay Village, FL
- NPI 1760541866
-
dba Walmart Pharmacy 10-7235
- Community/Retail Pharmacy
- Winterville, NC
- NPI 1467851881
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1558962183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8415 SW 107TH AVE APT 327W",
"city": "MIAMI",
"state": "FL",
"postal_code": "331734369",
"telephone_number": "786-251-5360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 S MEMORIAL DR",
"city": "WINTERVILLE",
"state": "NC",
"postal_code": "285908618",
"telephone_number": "252-917-6865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSSI",
"first_name": "JACQUELYN",
"middle_name": "MERCEDES",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-02",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS42004",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "29375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winterville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.