Individual provider Active NPI

Nicholas Edwin Jennings, PHARMD

  • Pharmacist
  • Watkins Glen, NY
National Provider Identifier
1922320209
Registry record updated Feb 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
054083 Issued in NY
Practice address
506 S Franklin St
Watkins Glen, NY 14891-1524
Phone
(607) 535-7350
Fax
(607) 535-2663
NPI assigned
Feb 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 054083 NY Primary

Addresses

Primary practice location

506 S Franklin St
Watkins Glen, NY 14891-1524

Mailing address

506 S Franklin St
Watkins Glen, NY 14891-1524
Phone (607) 535-7350

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

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Albany, L.L.C. Past Accepting new patients
CVS Albany LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267228800000",
    "number": "1922320209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 S FRANKLIN ST",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148911524",
            "telephone_number": "607-535-7350",
            "fax_number": "607-535-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 S FRANKLIN ST",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148911524",
            "telephone_number": "607-535-7350",
            "fax_number": "607-535-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "NICHOLAS",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-27",
        "last_updated": "2010-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "054083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkins Glen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2010; 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.