Individual provider Active NPI

Jared Briscoe, PHARMD

  • Pharmacist
  • Versailles, OH
National Provider Identifier
1730638859
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03225312 Issued in OH
Practice address
42 W Main St
Versailles, OH 45380-1214
Phone
(937) 526-3337
Fax
(937) 526-4118
NPI assigned
Sep 30, 2016
Last updated
Sep 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03225312 OH Primary

Addresses

Primary practice location

42 W Main St
Versailles, OH 45380-1214

Mailing address

42 W Main St
Versailles, OH 45380-1214
Phone (937) 526-3337

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

State licenses

LicenseStateTypeSpecialty
03225312OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaup Pharmacy, Inc. Past Accepting new patients
Jlkgt Investments 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": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1730638859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 W MAIN ST",
            "city": "VERSAILLES",
            "state": "OH",
            "postal_code": "453801214",
            "telephone_number": "937-526-3337",
            "fax_number": "937-526-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 W MAIN ST",
            "city": "VERSAILLES",
            "state": "OH",
            "postal_code": "453801214",
            "telephone_number": "937-526-3337",
            "fax_number": "937-526-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISCOE",
        "first_name": "JARED",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03225312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Versailles, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; 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.