NPIMap

Individual provider Active NPI

Jennifer R Chelli

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Sandusky, OH
National Provider Identifier
1770147449
Registry record updated Dec 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
14365 Issued in MD
Practice address
4020 Milan Rd
Sandusky, OH 44870-5892
Phone
(419) 609-3340
NPI assigned
Apr 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 14365 MD
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 03443513 OH
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 14365 MD Primary

Addresses

Primary practice location

4020 Milan Rd
Sandusky, OH 44870-5892

Mailing address

10812 Gaywood Dr
Hagerstown, MD 21740-7714
Phone (301) 766-9148

Other practice location 1

513 E Monroe St
Sandusky, OH 44870-3707
Phone (419) 625-2284

Other practice location 2

1650C Wesel Blvd
Hagerstown, MD 21740-5387
Phone (301) 766-9148

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
14365MDMDClinical Social Worker
03443513OHMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio CVS Stores, L.L.C. Past Accepting new patients
The Giant Company, LLC Past Accepting new patients
Ohio CVS Stores LLC Past Accepting new patients
The Giant Company, LLC Past Accepting new patients

Organizations & group practices 4

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": "1556323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703289600000",
    "number": "1770147449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10812 GAYWOOD DR",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217407714",
            "telephone_number": "301-766-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 MILAN RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705892",
            "telephone_number": "419-609-3340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "513 E Monroe St",
            "address_purpose": "LOCATION",
            "city": "Sandusky",
            "state": "OH",
            "postal_code": "448703707",
            "country_code": "US",
            "telephone_number": "419-625-2284",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1650C Wesel Blvd",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217405387",
            "country_code": "US",
            "telephone_number": "301-766-9148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHELLI",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-27",
        "last_updated": "2023-12-23",
        "certification_date": "2023-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "14365",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OH",
            "license": "03443513",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MD",
            "license": "14365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.