Active NPI
Bernadette Elise Jackson-Small, R.PH.
- Pharmacist
- Baton Rouge, LA
National Provider Identifier
1215228275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16937
- Practice address
- 5840 Plank Rd
Baton Rouge, LA 70805 - Phone
- (225) 355-4456
- Fax
- (225) 359-9063
- NPI assigned
- Apr 26, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16937 | LA | Primary |
| Pharmacist | 183500000X | 11393 | AL |
Addresses
Primary practice location
5840 Plank Rd
Baton Rouge, LA 70805
Mailing address
5840 Plank Rd
Baton Rouge, LA 70805-1320
Phone (225) 355-4456
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 |
|---|---|---|---|
| 16937 | LA | MD | Pharmacist |
| 11393 | AL | MD | Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303776000000",
"number": "1215228275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5840 PLANK RD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708051320",
"telephone_number": "225-355-4456",
"fax_number": "225-359-9063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5840 PLANK RD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "70805",
"telephone_number": "225-355-4456",
"fax_number": "225-359-9063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON-SMALL",
"first_name": "BERNADETTE",
"middle_name": "ELISE",
"name_prefix": "Mrs.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-26",
"last_updated": "2011-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "16937",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "11393",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.