Active NPI
Jaclyn June Edwards, RPH
- Pharmacist
- Rock Springs, WY
National Provider Identifier
1184239378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4267
- Practice address
- 70 Gateway Blvd
Rock Springs, WY 82901-5709 - Phone
- (307) 382-2536
- NPI assigned
- Sep 14, 2020
- Last updated
- Dec 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 4267 | WY | Primary |
Addresses
Primary practice location
70 Gateway Blvd
Rock Springs, WY 82901-5709
Mailing address
70 Gateway Blvd
Rock Springs, WY 82901-5709
Phone (307) 382-2536
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 |
|---|---|---|---|
| 4267 | WY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pharmworx LLC | Community/Retail Pharmacy | Past | Accepting new patients |
| Walgreen Co | Community/Retail Pharmacy | Past | Accepting new patients |
| Walgreen Co | Community/Retail Pharmacy | Past | Accepting new patients |
| Walgreen Co | Community/Retail Pharmacy | Past | Accepting new patients |
Organizations & group practices 4
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": "1600041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671408000000",
"number": "1184239378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 GATEWAY BLVD",
"city": "ROCK SPRINGS",
"state": "WY",
"postal_code": "829015709",
"telephone_number": "307-382-2536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 GATEWAY BLVD",
"city": "ROCK SPRINGS",
"state": "WY",
"postal_code": "829015709",
"telephone_number": "307-382-2536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "JACLYN",
"middle_name": "JUNE",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-14",
"last_updated": "2022-12-19",
"certification_date": "2022-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WY",
"license": "4267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Springs, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.