Active NPI
Jeffrey Lynn Robertson, PHARMD
- Pharmacist
- Phoenix, AZ
National Provider Identifier
1770865743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S018574
- Practice address
- 204 E Bell Rd
Phoenix, AZ 85022-2305 - Phone
- (602) 375-0093
- NPI assigned
- Sep 15, 2011
- Last updated
- Sep 15, 2011
- Sex
- Male
- Sole proprietor
- No
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 | S018574 | AZ | Primary |
Addresses
Primary practice location
204 E Bell Rd
Phoenix, AZ 85022-2305
Mailing address
8108 W Louise Dr
Peoria, AZ 85383-2184
Phone (602) 334-5297
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
| License | State | Type | Specialty |
|---|---|---|---|
| S018574 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1770865743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8108 W LOUISE DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853832184",
"telephone_number": "602-334-5297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 E BELL RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850222305",
"telephone_number": "602-375-0093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "JEFFREY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-15",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S018574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.