Active NPI
Jessica Lynn Clark, PHARMD
- Pharmacist
- Shepherdsville, KY
National Provider Identifier
1073124822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 020821
- Practice address
- 152 N Buckman St
Shepherdsville, KY 40165-5900 - Phone
- (502) 543-2202
- NPI assigned
- Aug 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 020821 | KY | Primary |
Addresses
Primary practice location
152 N Buckman St
Shepherdsville, KY 40165-5900
Mailing address
152 N Buckman St
Shepherdsville, KY 40165-5900
Phone (502) 543-2202
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
| License | State | Type | Specialty |
|---|---|---|---|
| 020821 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co. | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
152 N Buckman St
Shepherdsville, KY 40165
Phone (502) 543-2202
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597363200000",
"number": "1073124822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 N BUCKMAN ST",
"city": "SHEPHERDSVILLE",
"state": "KY",
"postal_code": "401655900",
"telephone_number": "502-543-2202",
"fax_number": "502-543-1040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 N BUCKMAN ST",
"city": "SHEPHERDSVILLE",
"state": "KY",
"postal_code": "401655900",
"telephone_number": "502-543-2202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-14",
"last_updated": "2020-08-14",
"certification_date": "2020-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "020821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shepherdsville, KY
- Leslie Brooke Caughron, APRN
- Central Kentucky Optometric Associates PSC (Uptown EyeCare)
- Katie Louise Chasteen Mason, LMT
- Thomas Cherry, LMFT
- Bryana Elizabeth Clark, PHARMD
- Clarkson Optometry Midwest Inc. (20/20 EyeCare)
- Cami Coke, PHARMD
- Maressa Coley, NP
- Allison Rae Collins, PA-C
- Colonial House I LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.