Jackienel Johnson

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

7734 Issued in AR

Practice address

16105 Chenal Pkwy Ste B
Little Rock, AR 72223-4824

Phone

(501) 217-7920

Fax

(501) 217-7922

NPI assigned

Dec 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • Little Rock, AR
  • NPI 1003831702
  NPD
• Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • Newport, KY
  • NPI 1104791078
  NPD (past)

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

{
    "created_epoch": "1577145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1053950907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16105 CHENAL PKWY STE B",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234824",
            "telephone_number": "501-217-7920",
            "fax_number": "501-217-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16105 CHENAL PKWY STE B",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234824",
            "telephone_number": "501-217-7920",
            "fax_number": "501-217-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JACKIENEL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-24",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AR",
            "license": "7734",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "7734",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AR",
            "license": "07734",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicia Mae Johnson, APRN
• Gail Johnson
• Greta Johnson
• Haley Jordan Johnson, AUD
• Hope Johnson
• Jacqueline Marie Johnson, NP-C
• James E Johnson II, MHPP
• James Wesley Johnson Jr., LPC
• Jamie Byron Johnson, O.D.
• Jamie D Johnson, MHPP

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.

Verify at the official NPI Registry.