Individual provider Active NPI

Reece Jackson, PHARMD

  • Pharmacist
  • Erlanger, KY
National Provider Identifier
1053046367
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03441882 Issued in KY
Practice address
1360 Dolwick Dr
Erlanger, KY 41018-3127
Phone
(859) 344-5555
Fax
(859) 344-5552
NPI assigned
Jul 20, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03441882 KY Primary

Addresses

Primary practice location

1360 Dolwick Dr
Erlanger, KY 41018-3127

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 344-5555

Other practice location 1

2170 Anderson Ferry Rd
Cincinnati, OH 45238-3328
Phone (513) 922-4271

Other practice location 2

10450 New Haven Rd
Harrison, OH 45030-2780
Phone (513) 367-5888

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
03441882KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1053046367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 DOLWICK DR",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "410183127",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2170 Anderson Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452383328",
            "country_code": "US",
            "telephone_number": "513-922-4271",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10450 New Haven Rd",
            "address_purpose": "LOCATION",
            "city": "Harrison",
            "state": "OH",
            "postal_code": "450302780",
            "country_code": "US",
            "telephone_number": "513-367-5888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "REECE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "03441882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erlanger, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.