Jennifer Denise McIntyre

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

30114462 Issued in KY

Practice address

14800 Fort Campbell Blvd
Oak Grove, KY 42262-8304

Phone

(270) 640-5848

Fax

(270) 640-5844

NPI assigned

Feb 13, 2021

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

Other identifiers 1

Other names 1

• Jennifer Denise Bunch Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1613174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1679166300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 CAROLINE ST",
            "city": "OAK GROVE",
            "state": "KY",
            "postal_code": "422629153",
            "telephone_number": "740-605-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 FORT CAMPBELL BLVD",
            "city": "OAK GROVE",
            "state": "KY",
            "postal_code": "422628304",
            "telephone_number": "270-640-5848",
            "fax_number": "270-640-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "JENNIFER",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-13",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "KY",
            "license": "30114462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CPHT",
            "identifier": "30114462",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BUNCH",
            "middle_name": "DENISE",
            "credential": "CPHT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Pharmacy Technician in Oak Grove, KY
• Providers in Oak Grove, KY by specialty
• Pharmacy Technician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2021; 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.