Individual provider Active NPI

Jessica Marie Stine, RPH

  • Pharmacist
  • Longmont, CO
National Provider Identifier
1780286567
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHA.0023034 Issued in CO
Practice address
551 S Hover St
Longmont, CO 80501-7920
Phone
(720) 864-4394
NPI assigned
Nov 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PHA.0023034 CO Primary

Addresses

Primary practice location

551 S Hover St
Longmont, CO 80501-7920

Mailing address

551 S Hover St
Longmont, CO 80501-7920

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

LicenseStateTypeSpecialty
PHA.0023034COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1780286567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 S HOVER ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805017920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 S HOVER ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805017920",
            "telephone_number": "720-864-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINE",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "PHA.0023034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.