Jenna Marie Mickonis, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP452666 Issued in PA

Practice address

2651 Easton Ave
Bethlehem, PA 18017-5015

Phone

(610) 865-3671

NPI assigned

Nov 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

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 and National Provider Directory roles.

• Pennsylvania CVS Pharmacy, L.L.C.

  • Pharmacy
  • Bethlehem, PA
  • NPI 1366546111
  NPD (past)

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1669075230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 BIRCHWOOD CIR APT 314",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180204563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 EASTON AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180175015",
            "telephone_number": "610-865-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKONIS",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP452666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Marie Michaels, DO
• Audrey Michalak, CRNP
• Jacquelyn Michalski, PA-C
• Allincia Michaud, MD, MPH
• Charles Joseph Micklosky Jr., R.PH.
• Kimberly Mickus, BA
• Kevin Joseph Mierzejewski, DO
• Daniel Joseph Mies, COUNSELOR
• Mary Elizabeth Mihalakis, D.M.D.
• Allison Mikita, PA-C

• Pharmacist in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.