Individual provider Active NPI

Jennifer Hale, PHARMD

  • Pharmacist
  • Stuart, FL
National Provider Identifier
1922745207
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS63555 Issued in FL
Practice address
622 Colorado Ave
Stuart, FL 34994-3087
Phone
(772) 287-3443
NPI assigned
May 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS63555 FL Primary

Addresses

Primary practice location

622 Colorado Ave
Stuart, FL 34994-3087

Mailing address

1908 SW Aguero St
Port St Lucie, FL 34953-1713
Phone (540) 521-0576

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
PS63555FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
KTJ Enterprises, LLC Pharmacist CurrentSince Feb 9, 2025 Accepting new patients
Prescription Shop of Stuart, Inc PastSince May 22, 2022 Accepting new patients

Locations

622 S Colorado Ave
Stuart, FL 34994
Phone (772) 287-3443

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": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1922745207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 SW AGUERO ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531713",
            "telephone_number": "540-521-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 COLORADO AVE",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943087",
            "telephone_number": "772-287-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "JENNIFER",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS63555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.