Jacob Alexander Enlow, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

1-14788 Issued in KS

Practice address

12221 Blue Valley Pkwy
Overland Park, KS 66213-2640

Phone

(913) 217-2052

Fax

(913) 217-2059

NPI assigned

Aug 28, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1851649545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15489 S WIDMER ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660626047",
            "telephone_number": "913-522-6923",
            "fax_number": "913-856-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 BLUE VALLEY PKWY",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662132640",
            "telephone_number": "913-217-2052",
            "fax_number": "913-217-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENLOW",
        "first_name": "JACOB",
        "middle_name": "ALEXANDER",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-14788",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "015561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Pharmacist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.