Individual provider Active NPI

Misty J Juarbe, RPH

  • Ambulatory Care Pharmacist
  • Jesup, GA
National Provider Identifier
1831780238
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
RPH018807 Issued in GA
Practice address
149 NW Broad St
Jesup, GA 31545-1310
Phone
(912) 427-3726
NPI assigned
Jan 28, 2021
Last updated
Jan 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X RPH018807 GA Primary

Addresses

Primary practice location

149 NW Broad St
Jesup, GA 31545-1310

Mailing address

149 NW Broad St
Jesup, GA 31545-1310
Phone (912) 427-3726

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
RPH018807GAMDAmbulatory Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ernest Knight Drugs, Inc CurrentSince Jan 31, 2021 Accepting new patients
Ernest Knight Drugs, Inc CurrentSince Jan 31, 2021 Accepting new patients

Locations

149 NW Broad St
Jesup, GA 31545
Phone (912) 427-3726

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, 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": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1831780238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 NW BROAD ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451310",
            "telephone_number": "912-427-3726",
            "fax_number": "912-427-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 NW BROAD ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451310",
            "telephone_number": "912-427-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUARBE",
        "first_name": "MISTY",
        "middle_name": "J",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "GA",
            "license": "RPH018807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.