Individual provider Active NPI

Alyssa Brooke Janecka, PHARMD

  • Pharmacist
  • Corsicana, TX
National Provider Identifier
1083223754
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
66887 Issued in TX
Practice address
201 S 15TH St
Corsicana, TX 75110-5138
Phone
(903) 874-6546
Fax
(903) 874-7569
NPI assigned
Jul 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 66887 TX Primary

Addresses

Primary practice location

201 S 15TH St
Corsicana, TX 75110-5138

Mailing address

2902 Overlook Cir
Corsicana, TX 75110-3940
Phone (903) 641-8343

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
66887TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
H-E-B, LP PastSince Aug 2, 2020 Accepting new patients

Organizations & group practices 1

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": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1083223754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 OVERLOOK CIR",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751103940",
            "telephone_number": "903-641-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S 15TH ST",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751105138",
            "telephone_number": "903-874-6546",
            "fax_number": "903-874-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANECKA",
        "first_name": "ALYSSA",
        "middle_name": "BROOKE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "66887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.