Active NPI
Jera Marie Dynda, PHARM D
- Pharmacist
- Bradford, PA
National Provider Identifier
1972835049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP440659
- Practice address
- 150 Main St
Tops Markets #610
Bradford, PA 16701-2024 - Phone
- (814) 363-9904
- NPI assigned
- Feb 1, 2010
- Last updated
- Feb 1, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP440659 | PA | Primary |
| Pharmacist | 183500000X | 054169-1 | NY | |
| Pharmacist | 183500000X | S015209 | AZ |
Addresses
Primary practice location
150 Main St
Tops Markets #610
Bradford, PA 16701-2024
Mailing address
150 Main St
Tops Markets #610
Bradford, PA 16701-2024
Phone (814) 363-9904
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
| License | State | Type | Specialty |
|---|---|---|---|
| S015209 | AZ | MD | Pharmacist |
| 054169-1 | NY | MD | Pharmacist |
| RP440659 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tops Markets LLC | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264982400000",
"number": "1972835049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 MAIN ST",
"address_2": "TOPS MARKETS #610",
"city": "BRADFORD",
"state": "PA",
"postal_code": "167012024",
"telephone_number": "814-363-9904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 MAIN ST",
"address_2": "TOPS MARKETS #610",
"city": "BRADFORD",
"state": "PA",
"postal_code": "167012024",
"telephone_number": "814-363-9904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYNDA",
"first_name": "JERA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-01",
"last_updated": "2010-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP440659",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "054169-1",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S015209",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.