Julie Ann Jackman, PHARMD, BC-ACP, BCPP

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

6110123 Issued in MN

Practice address

9850 51St Ave N Ste 102
Plymouth, MN 55442-3271

Phone

(763) 251-6920

Fax

(763) 251-6928

NPI assigned

May 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Dr. Julie Ann Gambaiani Professional name

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

Locations

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.

• Lotus LTC Pharmacy LLC

  dba Lotus Pharmacy

  • Long Term Care Pharmacy
  • Plymouth, MN
  • NPI 1629613005
  NPD
• Supervalu Pharmacies Inc

  dba Cub Pharmacy

  • Community/Retail Pharmacy
  • Blaine, MN
  • NPI 1043326457
  NPD (past)
• Supervalu Pharmacies Inc.

  dba Cub Pharmacy

  • Community/Retail Pharmacy
  • Burnsville, MN
  • NPI 1093517914
  NPD (past)

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1184627804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12595 CENTRAL AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55434",
            "telephone_number": "612-219-4547",
            "fax_number": "651-243-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 51ST AVE N STE 102",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554423271",
            "telephone_number": "763-251-6920",
            "fax_number": "763-251-6928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKMAN",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHARMD, BC-ACP, BCPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-27",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "116805-1",
            "primary": false
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "MN",
            "license": "4150621",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MN",
            "license": "6110123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY SPECIALTIES- BCPP",
            "identifier": "4150621",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY SPECIALTIES- BCACP",
            "identifier": "6110123",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "GAMBAIANI",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "PHARMD BCACP,BCPP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Marie Irvine, PTA
• John James Irwin Jr., CHID
• Suleiman Mohamed Isse, SULEIMAN
• J.Beck Chiropractic & Wellness, P.a.
• Jac Three, LLC (Nurse Next Door - Minnetonka, MN)
• Ethan Jared Jackson
• Michael Blake Jacob, PA-C
• Kimberly K Jacobsen, MD
• Laura Jacobson
• Pariz Jacox

• Ambulatory Care Pharmacist in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Ambulatory Care Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.