Active NPI
Jennifer L Gerdes, PHARMD, RPH
- Pharmacist
- Ithaca, NY
National Provider Identifier
1700108339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11000
- Practice address
- 87 Farrell Rd
Ithaca, NY 14850-9722 - Phone
- (607) 330-2011
- NPI assigned
- Feb 23, 2010
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11000 | NE | Primary |
| Pharmacist | 183500000X | 18283 | CO | |
| Pharmacist | 183500000X | 1846 | AK | |
| Pharmacist | 183500000X | 11494 | OR | |
| Pharmacist | 183500000X | 52297 | NY | |
| Pharmacist | 183500000X | S017658 | AZ |
Addresses
Primary practice location
87 Farrell Rd
Ithaca, NY 14850-9722
Mailing address
87 Farrell Rd
Ithaca, NY 14850-9722
Phone (607) 330-2011
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1846 | AK | MD | Pharmacist |
| S017658 | AZ | MD | Pharmacist |
| 18283 | CO | MD | Pharmacist |
| 11000 | NE | MD | Pharmacist |
| 52297 | NY | MD | Pharmacist |
| 11494 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291766400000",
"number": "1700108339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 FARRELL RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148509722",
"telephone_number": "607-330-2011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 FARRELL RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148509722",
"telephone_number": "607-330-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERDES",
"first_name": "JENNIFER",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-23",
"last_updated": "2010-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "11000",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "18283",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AK",
"license": "1846",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "11494",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "52297",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S017658",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.