Individual provider Active NPI

Jenna Marie Giacomin, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Crawfordsville, IN
National Provider Identifier
1740993914
Registry record updated Jan 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
26028810A Issued in IN
Practice address
1640 Crawfordsville Square Dr
Crawfordsville, IN 47933-3800
Phone
(765) 359-1113
NPI assigned
Jan 3, 2023
Last updated
Jan 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 26028810A IN Primary

Addresses

Primary practice location

1640 Crawfordsville Square Dr
Crawfordsville, IN 47933-3800

Mailing address

1201 S Main St
Crown Point, IN 46307-8481
Phone (219) 476-6452

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
26028810AINMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674864000000",
    "number": "1740993914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078481",
            "telephone_number": "219-476-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 CRAWFORDSVILLE SQUARE DR",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479333800",
            "telephone_number": "765-359-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIACOMIN",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-28",
        "certification_date": "2023-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IN",
            "license": "26028810A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crawfordsville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2023; 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.