Timothy L Jackson

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS36761 Issued in FL

Practice address

8585 Collier Blvd
Naples, FL 34114-3548

Phone

(239) 774-2938

Fax

(239) 774-6974

NPI assigned

Mar 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Publix Super Markets Inc

  • Community/Retail Pharmacy
  • Naples, FL
  • NPI 1518906486
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023137007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 14TH AVE SE",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341179240",
            "telephone_number": "239-455-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8585 COLLIER BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341143548",
            "telephone_number": "239-774-2938",
            "fax_number": "239-774-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TIMOTHY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS36761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard Leslie Jackson, PT
• Jon Ryan Jackson, M.D.
• Kelly Ann Jackson, SLP
• Margaret Jackson
• Sharon Christina Jackson, M.D.
• Jacob Madigan DPT LLC
• Aaron Matthew Jacobs, MD
• Brian Jacobson
• Michael Thomas Jacobson, M.D.
• Peter John Jaffe, D.O.

• Pharmacist in Naples, FL
• Providers in Naples, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.