Individual provider Active NPI

Jennifer Crisson, PHARMD

  • Pharmacist
  • Gardendale, AL
National Provider Identifier
1104465962
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21073 Issued in AL
Practice address
655 Fieldstown Rd
Gardendale, AL 35071-2411
Phone
(205) 608-4677
NPI assigned
Dec 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21073 AL Primary

Addresses

Primary practice location

655 Fieldstown Rd
Gardendale, AL 35071-2411

Mailing address

6486 Kimberly Loop
Pinson, AL 35126-3406

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
21073ALMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1104465962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6486 KIMBERLY LOOP",
            "city": "PINSON",
            "state": "AL",
            "postal_code": "351263406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 FIELDSTOWN RD",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350712411",
            "telephone_number": "205-608-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISSON",
        "first_name": "JENNIFER",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-27",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "21073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardendale, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.