Individual provider Active NPI

Jacqueline L Olin, PHARMD

  • Pharmacotherapy Pharmacist
  • Monroe, NC
National Provider Identifier
1790810158
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
RI25307 Issued in NJ
Practice address
3027 Brook Valley Run
Monroe, NC 28110-6336
Phone
(704) 218-8000
NPI assigned
Feb 23, 2007
Last updated
Dec 7, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 0070 0196 NC
Pharmacotherapy Pharmacist 1835P1200X 19296 NC
Pharmacotherapy Pharmacist 1835P1200X RI25307 NJ Primary

Addresses

Primary practice location

3027 Brook Valley Run
Monroe, NC 28110-6336

Mailing address

113 North Ames Street
Matthews Health Clinic
Matthews, NC 28105
Phone (704) 841-8882

Other names 1

  • Dr. Jacqueline L Fein Former name

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

LicenseStateTypeSpecialty
0070 0196NCMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
19296NCMDPharmacotherapy Pharmacist
RI25307NJMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
McAdams Free Clinic 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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1790810158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 NORTH AMES STREET",
            "address_2": "MATTHEWS HEALTH CLINIC",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "28105",
            "telephone_number": "704-841-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3027 BROOK VALLEY RUN",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281106336",
            "telephone_number": "704-218-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIN",
        "first_name": "JACQUELINE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NC",
            "license": "0070 0196",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "NC",
            "license": "19296",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "NJ",
            "license": "RI25307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "FEIN",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.