Individual provider Active NPI

Jacob Loberger, PHARMD

  • Pharmacist
  • Wauwatosa, WI
National Provider Identifier
1922694983
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19282-40 Issued in WI
Practice address
1441 N Mayfair Rd Ste 202
Wauwatosa, WI 53226-3281
Phone
(414) 433-1700
NPI assigned
Dec 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19282-40 WI Primary

Addresses

Primary practice location

1441 N Mayfair Rd Ste 202
Wauwatosa, WI 53226-3281

Mailing address

630 N Vel R Phillips Ave Unit 709
Milwaukee, WI 53203-2809
Phone (414) 520-0442

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
19282-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Assisted Living Pharmacy Service, LLC PastSince Dec 16, 2020 Accepting new patients

Organizations & group practices 1

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": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1922694983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 N VEL R PHILLIPS AVE UNIT 709",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532032809",
            "telephone_number": "414-520-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N MAYFAIR RD STE 202",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263281",
            "telephone_number": "414-433-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOBERGER",
        "first_name": "JACOB",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "19282-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.