Active NPI
Jennifer Nims
- Pharmacist
- Fair Lawn, NJ
National Provider Identifier
1720530546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI04003000
- Practice address
- 29-00 Broadway
Fair Lawn, NJ 07410-3912 - Phone
- (201) 475-8311
- NPI assigned
- Oct 27, 2016
- Last updated
- Dec 29, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4266 | NH | |
| Pharmacist | 183500000X | 28RI04003000 | NJ | Primary |
Addresses
Primary practice location
29-00 Broadway
Fair Lawn, NJ 07410-3912
Mailing address
29-00 Broadway
Fair Lawn, NJ 07410-3912
Phone (201) 475-8311
Other practice location 1
910 NH-16
Ossipee, NH 03864
Phone (603) 539-4822
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 |
|---|---|---|---|
| 4266 | NH | MD | Pharmacist |
| 28RI04003000 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Jersey CVS Pharmacy 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, 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": "1477526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609200000000",
"number": "1720530546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29-00 BROADWAY",
"city": "FAIR LAWN",
"state": "NJ",
"postal_code": "074103912",
"telephone_number": "201-475-8311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29-00 BROADWAY",
"city": "FAIR LAWN",
"state": "NJ",
"postal_code": "074103912",
"telephone_number": "201-475-8311"
}
],
"practiceLocations": [
{
"address_1": "910 NH-16",
"address_purpose": "LOCATION",
"city": "Ossipee",
"state": "NH",
"postal_code": "03864",
"country_code": "US",
"telephone_number": "603-539-4822",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NIMS",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-27",
"last_updated": "2020-12-29",
"certification_date": "2020-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NH",
"license": "4266",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI04003000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fair Lawn, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.