Active NPI
Jennifer Ann Kleiber, PHARMD
- Pharmacist
- Bay City, MI
National Provider Identifier
1598059487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302037108
- Practice address
- 4135 Wilder Rd
Bay City, MI 48706-2240 - Phone
- (989) 686-5143
- Fax
- (989) 686-5143
- NPI assigned
- Jun 8, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302037108 | MI | Primary |
Addresses
Primary practice location
4135 Wilder Rd
Bay City, MI 48706-2240
Mailing address
4135 Wilder Rd
T-0631
Bay City, MI 48706-2240
Phone (989) 686-5143
Other names 1
- Jennifer Ann Sullivan
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 |
|---|---|---|---|
| 5302037108 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients | |
| Target Corporation | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Bay City, MI
- NPI 1669494332
-
- Pharmacy
- Winston Salem, NC
- NPI 1699797258
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322179200000",
"number": "1598059487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4135 WILDER RD",
"address_2": "T-0631",
"city": "BAY CITY",
"state": "MI",
"postal_code": "487062240",
"telephone_number": "989-686-5143",
"fax_number": "989-686-5143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4135 WILDER RD",
"city": "BAY CITY",
"state": "MI",
"postal_code": "487062240",
"telephone_number": "989-686-5143",
"fax_number": "989-686-5143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEIBER",
"first_name": "JENNIFER",
"middle_name": "ANN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-08",
"last_updated": "2011-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302037108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "SULLIVAN",
"middle_name": "ANN",
"credential": "PHARMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bay City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.