Individual provider Active NPI

Jacqueline Fields Hackney, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Lebanon, VA
National Provider Identifier
1114174406
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
0202208532 Issued in VA
Practice address
495 E. Main St.
Lebanon, VA 24266
Phone
(276) 889-3700
NPI assigned
Aug 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 0202208532 VA Primary

Addresses

Primary practice location

495 E. Main St.
Lebanon, VA 24266

Mailing address

PO Box 2377
Lebanon, VA 24266-2377
Phone (276) 889-3700

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
0202208532VAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
C-Health PC Past Accepting new patients
C-Health PC 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.

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1114174406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2377",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242662377",
            "telephone_number": "276-889-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 E. MAIN ST.",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-889-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKNEY",
        "first_name": "JACQUELINE",
        "middle_name": "FIELDS",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "VA",
            "license": "0202208532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.