Individual provider Active NPI

Jacob Ryan Hildebrand, PHARMD

  • Pharmacist
  • Mechanicville, NY
National Provider Identifier
1952919391
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
033.0134423 Issued in VT
Practice address
3 Green Fields Dr
Mechanicville, NY 12118-3228
Phone
(248) 860-9606
NPI assigned
Jul 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 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 033.0134423 VT Primary

Addresses

Primary practice location

3 Green Fields Dr
Mechanicville, NY 12118-3228

Mailing address

3 Green Fields Dr
Mechanicville, NY 12118-3228
Phone (248) 860-9606

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
033.0134423VTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1952919391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 GREEN FIELDS DR",
            "city": "MECHANICVILLE",
            "state": "NY",
            "postal_code": "121183228",
            "telephone_number": "248-860-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 GREEN FIELDS DR",
            "city": "MECHANICVILLE",
            "state": "NY",
            "postal_code": "121183228",
            "telephone_number": "248-860-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRAND",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-22",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VT",
            "license": "033.0134423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.