Individual provider Active NPI

Jenifer Lynn Martin, PHARMD

  • Pharmacist
  • Denver, CO
National Provider Identifier
1760767651
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18232 Issued in CO
Practice address
1604 E 17TH Ave
Denver, CO 80218-1621
Phone
(303) 388-7504
Fax
(303) 388-7519
NPI assigned
Oct 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18232 CO Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 18232 CO

Addresses

Primary practice location

1604 E 17TH Ave
Denver, CO 80218-1621

Mailing address

1604 E 17TH Ave
Denver, CO 80218-1621
Phone (303) 388-7504

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
18232COMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Pharmacy, LLC. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1760767651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 E 17TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181621",
            "telephone_number": "303-388-7504",
            "fax_number": "303-388-7519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 E 17TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181621",
            "telephone_number": "303-388-7504",
            "fax_number": "303-388-7519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "18232",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CO",
            "license": "18232",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; 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.