Jacquelyn Keenan Martin, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

0202206150 Issued in VA

Practice address

1477 W Main St
Salem, VA 24153-3120

Phone

(540) 389-7251

Fax

(540) 387-1876

NPI assigned

Aug 29, 2011

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

Credentials

Registered Pharmacist

State licenses

Practice roles

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
  • Salem, VA
  • NPI 1073538773
  NPD (past)
• 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": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1093095507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11780",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240621780",
            "telephone_number": "704-661-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 W MAIN ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533120",
            "telephone_number": "540-389-7251",
            "fax_number": "540-387-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JACQUELYN",
        "middle_name": "KEENAN",
        "name_prefix": "Ms.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-29",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202206150",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "006153",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "10804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Markwood, FNP
• Kimberly Marlowe, LPTA
• Emily G Marston, PH.D.
• Christy Renee Martin, LPN
• Claudia Hildegard Martin, M.D.
• James Edward Martin Jr., D.O.
• Johnathan Martin, PSY.D.
• Kimberly Charise Martin, NP-C
• Matthew Santos Martinez
• Christin Nicole Martino, MD

• Pharmacist in Salem, VA
• Providers in Salem, VA by specialty
• Pharmacist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.

Verify at the official NPI Registry.