Travis Jackson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

2016026660 Issued in MO

Practice address

7907 State Line Rd
Kansas City, MO 64114-2015

Phone

(816) 444-2000

NPI assigned

Nov 30, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Missouri CVS Pharmacy LLC

  • Pharmacy
  • Saint Louis, MO
  • NPI 1073361952
  NPD (past)
• Missouri CVS Pharmacy, L.L.C.

  • Pharmacy
  • Kansas City, MO
  • NPI 1588763890
  NPD (past)

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1356945489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7907 STATE LINE RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641142015",
            "telephone_number": "816-444-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7907 STATE LINE RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641142015",
            "telephone_number": "816-444-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-100069",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2016026660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Marie Jackson, RN, IBCLC
• Morgan Jackson, RN, IBCLC
• Nathaniel Jackson
• Quiana R Jackson, DNP, MSW
• Sherelle Nicole Jackson, OTD, OTR/L
• Vanessa Rae Jackson, CRNA
• Victoria Renee Jackson, DO
• Warren Kieth Jackson, MD
• Aasems Jacob, MD
• Dany Jacob, MD

• Pharmacist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.