Active NPI
Jennifer Lynn Black, RPH
- Pharmacist
- Victoria, TX
National Provider Identifier
1154649457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29863
- Practice address
- 6106 N Navarro St
Victoria, TX 77904-1769 - Phone
- (361) 572-8575
- Fax
- (361) 578-5476
- NPI assigned
- May 11, 2010
- Last updated
- May 11, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 29863 | TX | Primary |
Addresses
Primary practice location
6106 N Navarro St
Victoria, TX 77904-1769
Mailing address
6106 N Navarro St
Victoria, TX 77904-1769
Phone (361) 572-8575
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29863 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H-E-B, LP | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273536000000",
"number": "1154649457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6106 N NAVARRO ST",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779041769",
"telephone_number": "361-572-8575",
"fax_number": "361-578-5476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6106 N NAVARRO ST",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779041769",
"telephone_number": "361-572-8575",
"fax_number": "361-578-5476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-11",
"last_updated": "2010-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "29863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victoria, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.