Active NPI
Jason Kishbaugh
- Pharmacist
- Coplay, PA
National Provider Identifier
1992307847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP440173
- Practice address
- 202 Chestnut St
Coplay, PA 18037-1252 - Phone
- (610) 262-6314
- NPI assigned
- Nov 14, 2020
- Last updated
- Nov 14, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP440173 | PA | Primary |
Addresses
Primary practice location
202 Chestnut St
Coplay, PA 18037-1252
Mailing address
202 Chestnut St
Coplay, PA 18037-1252
Phone (610) 262-6314
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
| License | State | Type | Specialty |
|---|---|---|---|
| RP440173 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Giant Company, LLC | Past | Accepting new patients | |
| The Giant Company, LLC | Past | Accepting new patients |
Organizations & group practices 2
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": "1605312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605312000000",
"number": "1992307847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 CHESTNUT ST",
"city": "COPLAY",
"state": "PA",
"postal_code": "180371252",
"telephone_number": "610-262-6314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 CHESTNUT ST",
"city": "COPLAY",
"state": "PA",
"postal_code": "180371252",
"telephone_number": "610-262-6314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISHBAUGH",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-14",
"last_updated": "2020-11-14",
"certification_date": "2020-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP440173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coplay, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.