Individual provider Active NPI

Jaimie Tucker

  • Pharmacist
  • Shelbyville, KY
National Provider Identifier
1114527231
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
011825 Issued in KY
Practice address
500 Taylorsville Rd
Shelbyville, KY 40065-8104
Phone
(502) 633-2592
Fax
(502) 633-4645
NPI assigned
Oct 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 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 011825 KY Primary

Addresses

Primary practice location

500 Taylorsville Rd
Shelbyville, KY 40065-8104

Mailing address

1404 Harley Creek CT
Fisherville, KY 40023-7781
Phone (502) 599-2478

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

State licenses

LicenseStateTypeSpecialty
011825KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1114527231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 HARLEY CREEK CT",
            "city": "FISHERVILLE",
            "state": "KY",
            "postal_code": "400237781",
            "telephone_number": "502-599-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 TAYLORSVILLE RD",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658104",
            "telephone_number": "502-633-2592",
            "fax_number": "502-633-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JAIMIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "011825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, KY

Sources for this page

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