Active NPI
Ryan Jackson, PHARMD
- Pharmacist
- Heflin, AL
National Provider Identifier
1194292060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15524
- Practice address
- 960 Ross St
Heflin, AL 36264-1164 - Phone
- (256) 463-2188
- NPI assigned
- Oct 30, 2018
- Last updated
- Oct 30, 2018
- Sex
- Male
- Sole proprietor
- No
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 | 15524 | AL | Primary |
Addresses
Primary practice location
960 Ross St
Heflin, AL 36264-1164
Mailing address
960 Ross St
Heflin, AL 36264-1164
Phone (256) 463-2188
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15524 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540857600000",
"number": "1194292060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 ROSS ST",
"city": "HEFLIN",
"state": "AL",
"postal_code": "362641164",
"telephone_number": "256-463-2188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "960 ROSS ST",
"city": "HEFLIN",
"state": "AL",
"postal_code": "362641164",
"telephone_number": "256-463-2188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "RYAN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-30",
"last_updated": "2018-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "15524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Heflin, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.