Jonathan Skutnick, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302040597 Issued in MI

Practice address

5500 Clyde Park Ave SW
Wyoming, MI 49509-9525

Phone

(616) 530-7110

NPI assigned

May 3, 2019

Last updated

May 3, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1750946927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2533 GREEN RUSH LN",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494648270",
            "telephone_number": "269-903-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 CLYDE PARK AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495099525",
            "telephone_number": "616-530-7110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Baldwin St",
            "address_purpose": "LOCATION",
            "city": "Jenison",
            "state": "MI",
            "postal_code": "494289753",
            "country_code": "US",
            "telephone_number": "616-667-2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKUTNICK",
        "first_name": "JONATHAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-03",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302040597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Sue Knopf Simpson, PT, CHT
• Rachel Simpson, DC
• Danielle Sinclair, DC
• Trisha Lynn Skippers, LPC, LLMFT
• Lynae Skobrak
• Pamela Slawson
• Kevin Sleboda, LMSW
• Sleep Well West Michigan
• Matthew Cesar Slendebroek, M.D.
• Stephanie Lynn-King Smit, PT

• Pharmacist in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.