Individual provider Active NPI

Jessica Behrens

  • Pharmacist
  • Luke AFB, AZ
National Provider Identifier
1992122543
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03230292 Issued in OH
Practice address
7219 N Litchfield Rd BLDG 1130
Luke AFB, AZ 85309-1529
Phone
(623) 856-7958
NPI assigned
Mar 20, 2014
Last updated
Mar 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03230292 OH Primary
Pharmacist 183500000X S020162 AZ

Addresses

Primary practice location

7219 N Litchfield Rd BLDG 1130
Luke AFB, AZ 85309-1529

Mailing address

7219 N Litchfield Rd BLDG 1130
Luke AFB, AZ 85309-1529
Phone (623) 856-7958

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

State licenses

LicenseStateTypeSpecialty
S020162AZMDPharmacist
03230292OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1992122543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7219 N LITCHFIELD RD BLDG 1130",
            "city": "LUKE AFB",
            "state": "AZ",
            "postal_code": "853091529",
            "telephone_number": "623-856-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7219 N LITCHFIELD RD BLDG 1130",
            "city": "LUKE AFB",
            "state": "AZ",
            "postal_code": "853091529",
            "telephone_number": "623-856-7958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHRENS",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-20",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03230292",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S020162",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Luke AFB, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; 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.