Active NPI
Ryan Elise Cheatham-Jackson, PHARM D
- Pharmacist
- La Plata, MD
National Provider Identifier
1295384451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26720
- Practice address
- 60 Shining Willow Way
La Plata, MD 20646-4224 - Phone
- (301) 934-5910
- NPI assigned
- Sep 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 26720 | MD | Primary |
Addresses
Primary practice location
60 Shining Willow Way
La Plata, MD 20646-4224
Mailing address
13821 Lord Fairfax PL
Upper Marlboro, MD 20772-5914
Phone (301) 938-0082
Other names 1
- Dr. Ryan Elise Cheatham-Jackson
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 |
|---|---|---|---|
| 26720 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568073600000",
"number": "1295384451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13821 LORD FAIRFAX PL",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207725914",
"telephone_number": "301-938-0082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 SHINING WILLOW WAY",
"city": "LA PLATA",
"state": "MD",
"postal_code": "206464224",
"telephone_number": "301-934-5910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEATHAM-JACKSON",
"first_name": "RYAN",
"middle_name": "ELISE",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-10",
"last_updated": "2019-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "26720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RYAN",
"last_name": "CHEATHAM-JACKSON",
"middle_name": "ELISE",
"prefix": "DR.",
"credential": "PHARM D",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in La Plata, MD
- Charles County Department of Health
- Charles County Freedom Landing, Inc.
- Charles County Nursing and Rehabilitation Center, Inc.
- Charles County Nursing Home Inc
- Charles County Rescue Squad Inc
- Patrick S Cieplak, DDS
- Citizens Run Inc
- Civista Clinical Sercives, LLC
- Civista Clinical Services, L.L.C.
- Civista Clinical Services, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.