DR. JESSICA NICHOLE BERGHAUS (NPI# 1669072559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669072559 |
| Entity Type | Individual |
| Full Name | DR. JESSICA NICHOLE BERGHAUS |
| Credential | PHARMD |
| Practice Address |
1001 N West St Olney IL 62450-3774 |
| Practice Telephone | 6183923464 |
| Mailing Telephone | 6183923464 |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051298238 | IL | Pharmacy Service Providers |
| Street Address |
1001 N WEST ST |
| City | OLNEY |
| State | IL |
| Zip Code | 62450-3774 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215954581 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 1001 N West St, Olney, IL 62450-3774 | 2006-07-16 |
| 1407456981 | Timothy John Sullens | Pharmacist | 1001 N West St, Olney, IL 62450-3774 | 2020-10-26 |
| 1689274136 | Danielle Renee Deters | Pharmacist | 1001 N West St, Olney, IL 62450-3774 | 2020-10-26 |
| 1972684975 | Wal-mart Stores, Inc | Technician/Technologist | 1001 N West St, Olney, IL 62450-3774 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851530091 | Donna Harris | Counselor | 515 West St. John Street, Olney, IL 62450 | 2009-02-11 |
| 1942476908 | Christa Dawn Jennette | Private Vehicle | 1113 Keiffer Dr, Olney, IL 62450 | 2008-04-30 |
| 1942491162 | Marion County Horizon Center D/b/a Richland Manor | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1066 West Main St, Olney, IL 62450 | 2007-08-05 |
| 1811100407 | Advanced Open Mri, Inc. | Clinic/Center | 605 East Main Street, Olney, IL 62450 | 2007-05-08 |
| 1548489958 | Frank Edward Gruber | Dentist | 1108 N East St, Olney, IL 62450 | 2007-04-24 |
| 1508084591 | Melvin Borja Escalona | Physical Therapist | 800 East Locust St., Olney, IL 62450 | 2007-04-23 |
| 1881769826 | Jeffrey Alan Kocher | Chiropractor | 731 S West St, Olney, IL 62450 | 2006-11-22 |
| 1336211523 | Patricia Lynn Kessler Bookhout | Dentist | 1104 North East, Olney, IL 62450 | 2006-11-14 |
| 1639159015 | Bowers Drug Store Inc | Pharmacy | 205 E Main, Olney, IL 62450 | 2006-01-20 |
| 1336137199 | South Eastern Illinois Counseling Center Inc | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450 | 2005-10-06 |
| Find all providers in zip 62450 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700853 | Sheldon Marc Godfrey | Pharmacist | 4408 Whimsey Ln, Olney, MD 20832-2833 | 2020-11-06 |
| 1821699265 | Marisa Witkin | Pharmacist | 18140 Village Mart Dr, Olney, MD 20832-1413 | 2020-11-03 |
| 1477021673 | Albert Ayernor | Pharmacist | 17608 Coatbridge Pl, Olney, MD 20832-2318 | 2018-11-06 |
| 1396285599 | Helen Yi | Pharmacist | 18111 Prince Philip Dr Ste 100, Olney, MD 20832-1503 | 2017-03-07 |
| 1831598473 | Anthony Chite | Pharmacist | 19105 Olney Mill Rd, Olney, MD 20832-1257 | 2014-08-20 |
| 1255730883 | Emily Thakur | Pharmacist | 17706 Bishops Castle Ct, Olney, MD 20832-1638 | 2014-08-20 |
| 1386066942 | Mahlet Aklile | Pharmacist | 17124 Thorntondale Ct, Olney, MD 20832-2534 | 2014-01-15 |
| 1346593720 | Issa Nesheiwat | Pharmacist | 17208 Moss Side Ln, Olney, MD 20832-2914 | 2012-10-22 |
| 1275852360 | Lori Alexander | Pharmacist | 3446 Laytonsville Rd, Olney, MD 20832-1734 | 2010-05-28 |
| 1114053733 | Cynthia Feinberg | Pharmacist | 3446 Olney Laytonsville Rd, Olney, MD 20832-1734 | 2007-02-26 |
| Find all providers in OLNEY | ||||
Please comment or provide details below to improve the information on DR. JESSICA NICHOLE BERGHAUS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.