Individual provider Active NPI

Jacki Sheryl Fox

  • Pharmacist
  • Burtonsville, MD
National Provider Identifier
1194326660
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14898 Issued in MD
Practice address
15618 Columbia Pike
Burtonsville, MD 20866-1630
Phone
(301) 421-4493
NPI assigned
Nov 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 14898 MD Primary

Addresses

Primary practice location

15618 Columbia Pike
Burtonsville, MD 20866-1630

Mailing address

5717 Western Sea Run
Clarksville, MD 21029-1665

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
14898MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Giant of Maryland LLC PastSince Nov 8, 2020 Accepting new patients
Giant of Maryland LLC PastSince Nov 8, 2020 Accepting new patients

Organizations & group practices 2

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": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1194326660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 WESTERN SEA RUN",
            "city": "CLARKSVILLE",
            "state": "MD",
            "postal_code": "210291665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15618 COLUMBIA PIKE",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661630",
            "telephone_number": "301-421-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "JACKI",
        "middle_name": "SHERYL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "14898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burtonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.