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Jacob Derby

Pharmacist β€’ Cranston, RI

Active NPI 1558211961 Individual Practitioner Male Practitioner
Practice location in NPPES

204 Garfield Ave
Cranston, RI 029207803

Call 4019438285 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

204 Garfield Ave

Cranston, RI 029207803

Telephone 4019438285
Organization at the Same NPPES Address or Phone
The Stop & Shop Supermarket Company Llc Facility NPI 1114952215

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2026

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Cranston and Rhode Island

79 active clinicians are listed under Pharmacist with a practice address in Cranston, RI (1,031 in Rhode Island).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Cranston

0% of these 79 clinicians have the CMS telehealth indicator.

0% of these 79 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-07-20
Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

License # reported to NPPES RI RPH06886

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Rhode Island State Medical Licensing Board.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location July 20, 2026

Registered at 204 GARFIELD AVE, CRANSTON, RI 029207803 (Tel: 4019438285)

πŸ“
Updated Business Mailing Address July 20, 2026

Registered at 204 GARFIELD AVE, CRANSTON, RI 029207803

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 20, 2026

Pharmacist (license number reported to NPPES: RI RPH06886)

βœ…
NPI Profile Active February 03, 2026

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) February 03, 2026

Registered at 300 QUAKER LN, WARWICK, RI 028860159 (Tel: 4018280533)

πŸ“
Business Mailing Address (Initial Record) February 03, 2026

Registered at 137 MISHNOCK RD, WEST GREENWICH, RI 028171676

πŸ‘€
Provider Name / Credentials (Initial Record) February 03, 2026

Recorded as JACOB DERBY

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 03, 2026

Pharmacy Technician (license number reported to NPPES: RI PHL06062)

🟒
Initial NPI Registration & Enumeration February 03, 2026

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1558211961
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 03, 2026
Last Update: July 20, 2026
Sole Proprietor: No

Mailing Address

204 Garfield Ave

Cranston, RI 029207803

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.