Individual provider Active NPI

Ross A Jerome Jr., RPH

  • Pharmacist
  • Brunswick, ME
National Provider Identifier
1821389974
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PR4275 Issued in ME
Practice address
156 Maine St
Rite Aid 4121
Brunswick, ME 04011
Phone
(207) 729-8100
Fax
(207) 729-1355
NPI assigned
Apr 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 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 PR4275 ME Primary

Addresses

Primary practice location

156 Maine St
Rite Aid 4121
Brunswick, ME 04011

Mailing address

156 Maine St
Rite Aid 4121
Brunswick, ME 04011
Phone (207) 729-8100

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
PR4275MEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303689600000",
    "number": "1821389974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 MAINE ST",
            "address_2": "RITE AID 4121",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "04011",
            "telephone_number": "207-729-8100",
            "fax_number": "207-729-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 MAINE ST",
            "address_2": "RITE AID 4121",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "04011",
            "telephone_number": "207-729-8100",
            "fax_number": "207-729-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEROME",
        "first_name": "ROSS",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-25",
        "last_updated": "2011-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR4275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.