Active NPI
Jennifer Lynn Stelloh
- Pharmacist
- Mancelona, MI
National Provider Identifier
1689127300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302041365
- Practice address
- 617 N Williams St
Mancelona, MI 49659-9766 - Phone
- (231) 587-8491
- NPI assigned
- Jul 28, 2016
- 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 | 5302041365 | MI | Primary |
Addresses
Primary practice location
617 N Williams St
Mancelona, MI 49659-9766
Mailing address
2425 Orchard Circle Dr Apt 15
Traverse City, MI 49686-1550
Phone (616) 885-0034
Other practice location 1
2750 Cook Rd
West Branch, MI 48661-8744
Phone (989) 343-9761
Other practice location 2
8917 E 34 Rd
Cadillac, MI 49601-7500
Phone (231) 775-9699
Other practice location 3
1180 M 32 W
Alpena, MI 49707-8105
Phone (989) 354-0731
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302041365 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Fare, LLC | Past | Accepting new patients | |
| Family Fare, LLC | 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": "1469664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741651200000",
"number": "1689127300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 ORCHARD CIRCLE DR APT 15",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496861550",
"telephone_number": "616-885-0034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 N WILLIAMS ST",
"city": "MANCELONA",
"state": "MI",
"postal_code": "496599766",
"telephone_number": "231-587-8491"
}
],
"practiceLocations": [
{
"address_1": "2750 Cook Rd",
"address_purpose": "LOCATION",
"city": "West Branch",
"state": "MI",
"postal_code": "486618744",
"country_code": "US",
"telephone_number": "989-343-9761",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8917 E 34 Rd",
"address_purpose": "LOCATION",
"city": "Cadillac",
"state": "MI",
"postal_code": "496017500",
"country_code": "US",
"telephone_number": "231-775-9699",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1180 M 32 W",
"address_purpose": "LOCATION",
"city": "Alpena",
"state": "MI",
"postal_code": "497078105",
"country_code": "US",
"telephone_number": "989-354-0731",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STELLOH",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-28",
"last_updated": "2025-03-11",
"certification_date": "2025-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302041365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mancelona, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.