Individual provider Active NPI

Jennifer Ford

  • Pharmacist
  • Grafton, WI
National Provider Identifier
1770911646
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13092-040 Issued in WI
Practice address
1771 Wisconsin Ave
Grafton, WI 53024-2437
Phone
(262) 375-0016
NPI assigned
Oct 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13092-040 WI Primary

Addresses

Primary practice location

1771 Wisconsin Ave
Grafton, WI 53024-2437

Mailing address

1771 Wisconsin Ave
Grafton, WI 53024-2437

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
13092-040WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1770911646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 WISCONSIN AVE",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530242437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 WISCONSIN AVE",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530242437",
            "telephone_number": "262-375-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-31",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "13092-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; 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.