Active NPI
Jaclyn Randazzo, PHARMD
- Pharmacist
- Solon, OH
National Provider Identifier
1619379773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03233654
- Practice address
- 6270 Som Center Rd
Solon, OH 44139-2913 - Phone
- (440) 836-0494
- Fax
- (440) 836-0498
- NPI assigned
- Sep 19, 2014
- Last updated
- Mar 30, 2023
- Sex
- Female
- Sole proprietor
- No
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 | 03233654 | OH | Primary |
Addresses
Primary practice location
6270 Som Center Rd
Solon, OH 44139-2913
Mailing address
16751 Lucky Bell LN
Auburn TWP, OH 44023-5187
Phone (216) 339-1554
Other practice location 1
520 Broadway Ave
Bedford, OH 44146-2724
Phone (440) 232-6500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03233654 | Other | OH | OHIO STATE BOARD OF PHARMACY |
| 836738 | Other | OH | NATIONAL ASSOCIATION OF BOARDS OF PHARMACY |
Other names 1
- Dr. Jaclyn Purgert
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 |
|---|---|---|---|
| 03233654 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680134400000",
"number": "1619379773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16751 LUCKY BELL LN",
"city": "AUBURN TWP",
"state": "OH",
"postal_code": "440235187",
"telephone_number": "216-339-1554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6270 SOM CENTER RD",
"city": "SOLON",
"state": "OH",
"postal_code": "441392913",
"telephone_number": "440-836-0494",
"fax_number": "440-836-0498"
}
],
"practiceLocations": [
{
"address_1": "520 Broadway Ave",
"address_purpose": "LOCATION",
"city": "Bedford",
"state": "OH",
"postal_code": "441462724",
"country_code": "US",
"telephone_number": "440-232-6500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RANDAZZO",
"first_name": "JACLYN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-19",
"last_updated": "2023-03-30",
"certification_date": "2023-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03233654",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO STATE BOARD OF PHARMACY",
"identifier": "03233654",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL ASSOCIATION OF BOARDS OF PHARMACY",
"identifier": "836738",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JACLYN",
"last_name": "PURGERT",
"prefix": "DR.",
"credential": "PHARMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Solon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.