Individual provider Active NPI

Timothy Wyatt Jaggers, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Elizabethtown, KY
National Provider Identifier
1154250074
Registry record updated May 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
022761 Issued in KY
Practice address
3040 Dolphin Dr
Elizabethtown, KY 42701-7125
Phone
(270) 737-4578
NPI assigned
May 16, 2026
Last updated
May 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2026

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 022761 KY Primary

Addresses

Primary practice location

3040 Dolphin Dr
Elizabethtown, KY 42701-7125

Mailing address

3040 Dolphin Dr
Elizabethtown, KY 42701-7125
Phone (270) 737-4578

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
022761KYMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1778889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778889600000",
    "number": "1154250074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 DOLPHIN DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017125",
            "telephone_number": "270-737-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 DOLPHIN DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017125",
            "telephone_number": "270-737-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGGERS",
        "first_name": "TIMOTHY",
        "middle_name": "WYATT",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-16",
        "last_updated": "2026-05-16",
        "certification_date": "2026-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "KY",
            "license": "022761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2026; 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.