Active NPI
Jessica Clack Sifakis, PHARMD
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1285915637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 43785
- Practice address
- 841 Prudential Dr Ste 180
Jacksonville, FL 32207-8350 - Phone
- (904) 202-4600
- NPI assigned
- Aug 30, 2011
- Last updated
- Aug 11, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 43785 | FL | Primary |
Addresses
Primary practice location
841 Prudential Dr Ste 180
Jacksonville, FL 32207-8350
Mailing address
1370 13TH Ave S, Mob a, Ste 118
Jacksonville Beach, FL 32250-3206
Phone (904) 376-3534
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 |
|---|---|---|---|
| 43785 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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": "1314662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660176000000",
"number": "1285915637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1370 13TH AVE S, MOB A, STE 118",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "322503206",
"telephone_number": "904-376-3534",
"fax_number": "904-202-4639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "841 PRUDENTIAL DR STE 180",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078350",
"telephone_number": "904-202-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIFAKIS",
"first_name": "JESSICA",
"middle_name": "CLACK",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-30",
"last_updated": "2022-08-11",
"certification_date": "2022-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "43785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.