Individual provider Active NPI

Jessica Lolies, CPT

  • Pharmacy Technician
  • Wimauma, FL
National Provider Identifier
1750165544
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
RPT39860 Issued in FL
Practice address
4928 State Road 674
Wimauma, FL 33598-3510
Phone
(813) 633-1463
NPI assigned
Aug 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X RPT39860 FL Primary

Addresses

Primary practice location

4928 State Road 674
Wimauma, FL 33598-3510

Mailing address

4928 State Road 674
Wimauma, FL 33598-3510
Phone (813) 633-1463

Other identifiers 2

IdentifierTypeStateIssuer
RPT39860OtherFLFLORIDA REGISTERED PHARMACY TECHNICIAN
2503-8424OtherEXCPT (CPHT)

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

LicenseStateTypeSpecialty
RPT39860FLMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1750165544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4928 STATE ROAD 674",
            "city": "WIMAUMA",
            "state": "FL",
            "postal_code": "335983510",
            "telephone_number": "813-633-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4928 STATE ROAD 674",
            "city": "WIMAUMA",
            "state": "FL",
            "postal_code": "335983510",
            "telephone_number": "813-633-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOLIES",
        "first_name": "JESSICA",
        "credential": "CPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "FL",
            "license": "RPT39860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA REGISTERED PHARMACY TECHNICIAN",
            "identifier": "RPT39860",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCPT (CPHT)",
            "identifier": "2503-8424",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wimauma, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.