Active NPI
Jake Nichols, PHARM.D., MBA
- Psychiatric Pharmacist
- Natick, MA
National Provider Identifier
1962731398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- 024752
- Practice address
- 41 Walnut St
Natick, MA 01760-2848 - Phone
- (617) 529-6312
- NPI assigned
- Dec 14, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Pharmacist | 1835P1300X | 024752 | MA | Primary |
| Pharmacotherapy Pharmacist | 1835P1200X | 024752 | MA |
Addresses
Primary practice location
41 Walnut St
Natick, MA 01760-2848
Mailing address
41 Walnut St
Natick, MA 01760-2848
Phone (617) 529-6312
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 024752 | Other | MA | MASSACHUSETTS PHARMACY LICENSE |
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
- Master of Business Administration, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024752 | MA | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444176000000",
"number": "1962731398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 WALNUT ST",
"city": "NATICK",
"state": "MA",
"postal_code": "017602848",
"telephone_number": "617-529-6312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 WALNUT ST",
"city": "NATICK",
"state": "MA",
"postal_code": "017602848",
"telephone_number": "617-529-6312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "JAKE",
"credential": "PHARM.D., MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-12-14",
"last_updated": "2015-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "MA",
"license": "024752",
"primary": true
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MA",
"license": "024752",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSACHUSETTS PHARMACY LICENSE",
"identifier": "024752",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Natick, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.