Active NPI
Wendy Marie Jackson, PHARM. D
- Pharmacist
- Sioux Falls, SD
National Provider Identifier
1093082901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5187
- Practice address
- 1507 W 51St St
Sioux Falls, SD 57105-6648 - Phone
- (605) 338-7007
- Fax
- (800) 547-7304
- NPI assigned
- Nov 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5187 | SD | Primary |
| Pharmacist | 183500000X | 19497 | IA | |
| Pharmacist | 183500000X | 12818 | NE |
Addresses
Primary practice location
1507 W 51St St
Sioux Falls, SD 57105-6648
Mailing address
PO Box 466
108 Grand Ave
Harrisburg, SD 57032-0466
Phone (712) 899-2486
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 |
|---|---|---|---|
| 19497 | IA | MD | Pharmacist |
| 12818 | NE | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pharmacy Corporation of America | Past | Accepting new patients | |
| Pharmacy Corporation of America | Past | Accepting new patients |
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.
-
dba Pharmerica
- Long Term Care Pharmacy
- Sioux Falls, SD
- NPI 1083647663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321747200000",
"number": "1093082901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 466",
"address_2": "108 GRAND AVE",
"city": "HARRISBURG",
"state": "SD",
"postal_code": "570320466",
"telephone_number": "712-899-2486",
"fax_number": "800-547-7304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1507 W 51ST ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571056648",
"telephone_number": "605-338-7007",
"fax_number": "800-547-7304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "WENDY",
"middle_name": "MARIE",
"credential": "PHARM. D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-20",
"last_updated": "2011-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SD",
"license": "5187",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "19497",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "12818",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.