Susan Elizabeth Jefferson I, PHARMACIST

Primary specialty

PharmacistTaxonomy code 183500000X

License

03-2-21176 Issued in OH

Practice address

4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5546

Phone

(937) 257-0837

NPI assigned

Oct 20, 2006

Sex

Female

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

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760564280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E. WALNUT STREET",
            "city": "ST. PARIS",
            "state": "OH",
            "postal_code": "43072",
            "telephone_number": "937-668-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335546",
            "telephone_number": "937-257-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "name_suffix": "I",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03-2-21176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Huelskamp, PHARMD
• Eirleen Young-Ju Hyun, DMD
• Peter Douglas Ingoldsby, DDS
• Andrea Irons, MSW, LISW
• Keith Janda
• Joseph Edward Johnson, D.M.D
• Latasha J Johnson, PA-C
• Roy Lee Johnson III, M.D.
• Joseph M. Jones, MD
• Hyon J Joo, D.O.

• Pharmacist in Wright Patterson Afb, OH
• Providers in Wright Patterson Afb, OH by specialty
• Pharmacist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.