Vonnetta Renee Jackson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH031911 Issued in GA

Practice address

730 N Church St
Thomaston, GA 30286-3618

Phone

(706) 648-4048

NPI assigned

Sep 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Ingles Markets Inc

  • Community/Retail Pharmacy
  • Acworth, GA
  • NPI 1023872108
  NPD (past)
• Ingles Markets Inc

  • Community/Retail Pharmacy
  • Thomaston, GA
  • NPI 1538585179
  NPD (past)

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1154935666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N CHURCH ST",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302863618",
            "telephone_number": "706-648-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N CHURCH ST",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302863618",
            "telephone_number": "706-648-4048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3477 Greenbriar Rd",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312044201",
            "country_code": "US",
            "telephone_number": "478-414-1168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "VONNETTA",
        "middle_name": "RENEE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH031911",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "28669",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hughston Medical Group, PC
• Hutchins Chiropractic Clinic
• Ingles Markets Inc
• Lisa Gaye Ingram, MSN, APRN, FNP
• Melanie B Jackson, L.PN
• Felicia Annette Jarrell, NP
• Lisa Marie Jenkins, FNP-C
• Susan Leanne Jobe, FNP-C
• Kionna Johnson, PHARMD
• Shauna Johnson, APRN, PMHNP

• Pharmacist in Thomaston, GA
• Providers in Thomaston, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.