Individual provider Active NPI

Jamie Green

  • Pharmacist
  • Kyle, TX
National Provider Identifier
1275833048
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
34854 Issued in TX
Practice address
5188 Kyle Center Dr
T-2725
Kyle, TX 78640-6137
Phone
(512) 268-7551
Fax
(512) 268-7551
NPI assigned
Oct 27, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 34854 TX Primary

Addresses

Primary practice location

5188 Kyle Center Dr
T-2725
Kyle, TX 78640-6137

Mailing address

5188 Kyle Center Dr
T-2725
Kyle, TX 78640-6137
Phone (512) 268-7551

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
34854TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1275833048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5188 KYLE CENTER DR",
            "address_2": "T-2725",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406137",
            "telephone_number": "512-268-7551",
            "fax_number": "512-268-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5188 KYLE CENTER DR",
            "address_2": "T-2725",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406137",
            "telephone_number": "512-268-7551",
            "fax_number": "512-268-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JAMIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-27",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "34854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kyle, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.

Verify at the official NPI Registry.