Active NPI
Jacqueline Suzanne Skelton, RPH
- Pharmacist
- Rochester, NY
National Provider Identifier
1770639627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 048669
- Practice address
- 3750 Mount Read Blvd
Rochester, NY 14616-3436 - Phone
- (585) 581-5101
- Fax
- (585) 581-2646
- NPI assigned
- Jan 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 048669 | NY | Primary |
Addresses
Primary practice location
3750 Mount Read Blvd
Rochester, NY 14616-3436
Mailing address
30 Wind Way Cir
Rochester, NY 14624-2465
Other practice location 1
81 Main St
Batavia, NY 14020-2101
Phone (585) 344-1570
Other names 1
- Miss Jacqueline Suzanne Kloch
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048669 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Casey Group LLC | Past | Accepting new patients | |
| Louraul Pharmaceutics Inc | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Community/Retail Pharmacy
- Batavia, NY
- NPI 1962565598
-
- Community/Retail Pharmacy
- Batavia, NY
- NPI 1346638277
-
- Pharmacy
- Brooklyn, RI
- NPI 1679459481
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647216000000",
"number": "1770639627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 WIND WAY CIR",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146242465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3750 MOUNT READ BLVD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146163436",
"telephone_number": "585-581-5101",
"fax_number": "585-581-2646"
}
],
"practiceLocations": [
{
"address_1": "81 Main St",
"address_purpose": "LOCATION",
"city": "Batavia",
"state": "NY",
"postal_code": "140202101",
"country_code": "US",
"telephone_number": "585-344-1570",
"fax_number": "585-344-2946",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SKELTON",
"first_name": "JACQUELINE",
"middle_name": "SUZANNE",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2022-03-14",
"certification_date": "2022-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "048669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JACQUELINE",
"last_name": "KLOCH",
"middle_name": "SUZANNE",
"prefix": "MISS",
"credential": "RPH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.