Individual provider Active NPI

Jamie Folk

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Mansfield, TX
National Provider Identifier
1164052114
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
55129 Issued in TX
Practice address
3001 Matlock Rd
Mansfield, TX 76063-3302
Phone
(817) 473-0081
Fax
(817) 473-0972
NPI assigned
Jan 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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 55129 TX Primary

Addresses

Primary practice location

3001 Matlock Rd
Mansfield, TX 76063-3302

Mailing address

3612 N Belt Line Rd
Irving, TX 75062-7899
Phone (972) 252-6450

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
55129TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Texas LP PastSince Jan 19, 2020 Accepting new patients
Kroger Texas L P PastSince Oct 19, 2020 Accepting new patients
Kroger Texas L P PastSince Jan 19, 2020 Accepting new patients

Organizations & group practices 3

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": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1164052114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 N BELT LINE RD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750627899",
            "telephone_number": "972-252-6450",
            "fax_number": "972-252-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 MATLOCK RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633302",
            "telephone_number": "817-473-0081",
            "fax_number": "817-473-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLK",
        "first_name": "JAMIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "55129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

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