Individual provider Active NPI

Jessica Lynn Southward, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Richmond, VA
National Provider Identifier
1164787529
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
RPH023611 Issued in GA
Practice address
1201 Broad Rock Blvd
Richmond, VA 23249-7708
Phone
(804) 675-5000
NPI assigned
Jul 11, 2012
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 0202209590 VA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 49635 TX
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH023611 GA Primary

Addresses

Primary practice location

1201 Broad Rock Blvd
Richmond, VA 23249-7708

Mailing address

4114 University Blvd
Dallas, TX 75205-1633
Phone (540) 818-2803

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
RPH023611GAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
49635TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
0202209590VAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1164787529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 UNIVERSITY BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752051633",
            "telephone_number": "540-818-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232497708",
            "telephone_number": "804-675-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHWARD",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "VA",
            "license": "0202209590",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "49635",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "GA",
            "license": "RPH023611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.