Individual provider Active NPI

Jeffrey Wallace Jansen, PHARM.D.

  • Infectious Diseases Pharmacist
  • Louisville, KY
National Provider Identifier
1861868291
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Diseases PharmacistTaxonomy code 1835I0206X
License
PHA-PHA-LIC-43413 Issued in MT
Practice address
800 Zorn Ave
Louisville, KY 40206-1433
Phone
(502) 287-4000
Fax
(502) 287-6094
NPI assigned
Aug 20, 2015
Last updated
Sep 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Diseases Pharmacist 1835I0206X PHA-PHA-LIC-43413 MT Primary
Pharmacist 183500000X RPH-0014882 OR

Addresses

Primary practice location

800 Zorn Ave
Louisville, KY 40206-1433

Mailing address

800 Zorn Ave
Louisville, KY 40206-1433
Phone (502) 287-4000

Other practice location 1

915 N Grand Blvd
JC 119
Saint Louis, MO 63106-1621
Phone (314) 652-4100 ext. 51167

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
RPH-0014882ORMDPharmacist
PHA-PHA-LIC-43413MTMDMedical license number

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1861868291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ZORN AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061433",
            "telephone_number": "502-287-4000",
            "fax_number": "502-287-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ZORN AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061433",
            "telephone_number": "502-287-4000",
            "fax_number": "502-287-6094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 N Grand Blvd",
            "address_2": "JC 119",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631061621",
            "country_code": "US",
            "telephone_number": "314-652-4100 x51167",
            "fax_number": "314-289-7688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "JEFFREY",
        "middle_name": "WALLACE",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-20",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835I0206X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Infectious Diseases",
            "state": "MT",
            "license": "PHA-PHA-LIC-43413",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0014882",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.

Verify at the official NPI Registry.