Individual provider Active NPI

Jehan Jazrawi, R.PH.

  • Pharmacist
  • Troy, MI
National Provider Identifier
1790069649
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302032015 Issued in MI
Practice address
3930 Mesa Dr
Troy, MI 48083-6510
Phone
(248) 910-7073
NPI assigned
Oct 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302032015 MI Primary

Addresses

Primary practice location

3930 Mesa Dr
Troy, MI 48083-6510

Mailing address

3930 Mesa Dr
Troy, MI 48083-6510
Phone (248) 910-7073

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
5302032015MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1790069649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 MESA DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480836510",
            "telephone_number": "248-910-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 MESA DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480836510",
            "telephone_number": "248-910-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAZRAWI",
        "first_name": "JEHAN",
        "name_prefix": "Mrs.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302032015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.

Verify at the official NPI Registry.