Individual provider Active NPI

Jessie Rosloniec

  • Pharmacy Technician
  • Grand Rapids, MI
National Provider Identifier
1790353043
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
5303028105 Issued in MI
Practice address
2036 Lake Michigan Dr NW
Grand Rapids, MI 49504-4743
Phone
(616) 453-2473
NPI assigned
Jun 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 5303028105 MI Primary

Addresses

Primary practice location

2036 Lake Michigan Dr NW
Grand Rapids, MI 49504-4743

Mailing address

10837 64TH Ave
Allendale, MI 49401-9777
Phone (616) 291-4303

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
5303028105MIMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Michigan Inc PastSince Jun 22, 2021 Accepting new patients
Rite Aid of Michigan Inc PastSince Jun 22, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1790353043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10837 64TH AVE",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019777",
            "telephone_number": "616-291-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2036 LAKE MICHIGAN DR NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044743",
            "telephone_number": "616-453-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSLONIEC",
        "first_name": "JESSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "MI",
            "license": "5303028105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.