Active NPI
Jessica Roach
- Pharmacist
- California, MD
National Provider Identifier
1689218935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 25388
- Practice address
- 44900 Saint Andrews Church Rd
California, MD 20619-2106 - Phone
- (301) 737-2518
- Fax
- (301) 737-2679
- NPI assigned
- Oct 30, 2019
- 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 | 25388 | MD | Primary |
Addresses
Primary practice location
44900 Saint Andrews Church Rd
California, MD 20619-2106
Mailing address
21510 Rominger CT
Lexington Park, MD 20653-2754
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 |
|---|---|---|---|
| 25388 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harris Teeter LLC | Past | Accepting new patients |
Organizations & group practices 1
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
- Apex, NC
- NPI 1225856859
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572393600000",
"number": "1689218935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21510 ROMINGER CT",
"city": "LEXINGTON PARK",
"state": "MD",
"postal_code": "206532754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44900 SAINT ANDREWS CHURCH RD",
"city": "CALIFORNIA",
"state": "MD",
"postal_code": "206192106",
"telephone_number": "301-737-2518",
"fax_number": "301-737-2679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROACH",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-30",
"last_updated": "2019-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "25388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in California, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.