Active NPI
Kimberly Ann Jacques, RPH
- Pharmacist
- Wall, NJ
National Provider Identifier
1972811537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI02503300
- Practice address
- 1732 Route 35
Wall, NJ 07719-3440 - Phone
- (732) 280-2336
- Fax
- (732) 280-2026
- NPI assigned
- Sep 16, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI02503300 | NJ | Primary |
Addresses
Primary practice location
1732 Route 35
Wall, NJ 07719-3440
Mailing address
1732 Route 35
Wall, NJ 07719-3440
Phone (732) 280-2336
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI02503300 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284595200000",
"number": "1972811537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1732 ROUTE 35",
"city": "WALL",
"state": "NJ",
"postal_code": "077193440",
"telephone_number": "732-280-2336",
"fax_number": "732-280-2026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1732 ROUTE 35",
"city": "WALL",
"state": "NJ",
"postal_code": "077193440",
"telephone_number": "732-280-2336",
"fax_number": "732-280-2026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACQUES",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-16",
"last_updated": "2010-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI02503300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wall, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.