Individual provider Active NPI

Justin M Jakab, PHARMD, RPH

  • Pharmacist
  • Cleveland, OH
National Provider Identifier
1902100175
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03228028 Issued in OH
Practice address
1730 W 25TH St
Cleveland, OH 44113-3108
Phone
(216) 696-7055
Fax
(216) 696-7490
NPI assigned
Jan 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 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 03228028 OH Primary

Addresses

Primary practice location

1730 W 25TH St
Cleveland, OH 44113-3108

Mailing address

1320 Bonnie LN
Mayfield Heights, OH 44124-1806
Phone (440) 796-4340

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
03228028OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1902100175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 BONNIE LN",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441241806",
            "telephone_number": "440-796-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 W 25TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133108",
            "telephone_number": "216-696-7055",
            "fax_number": "216-696-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKAB",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-03",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03228028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.