Active NPI
Marisa Rose Jacobs
- Pharmacist
- Dunmore, PA
National Provider Identifier
1811765621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP457254
- Practice address
- 1228 Oneill Hwy
Dunmore, PA 18512-1708 - Phone
- (570) 346-4593
- NPI assigned
- Dec 12, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP457254 | PA | Primary |
Addresses
Primary practice location
1228 Oneill Hwy
Dunmore, PA 18512-1708
Mailing address
461 Nott St
Schenectady, NY 12308-1812
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
| License | State | Type | Specialty |
|---|---|---|---|
| RP457254 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Price Chopper Operating Co of PA Inc | Past | Accepting new patients | |
| Price Chopper Operating Co of PA Inc | Past | 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.
-
- Pharmacy
- Montrose, PA
- NPI 1316313539
-
- Community/Retail Pharmacy
- Dunmore, PA
- NPI 1811900038
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702339200000",
"number": "1811765621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "461 NOTT ST",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "123081812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1228 ONEILL HWY",
"city": "DUNMORE",
"state": "PA",
"postal_code": "185121708",
"telephone_number": "570-346-4593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "MARISA",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-12",
"last_updated": "2023-12-12",
"certification_date": "2023-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP457254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dunmore, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.