Individual provider Active NPI

Jessica Lynn Cameron, PHARMD

  • Pharmacist
  • Broken Arrow, OK
National Provider Identifier
1427834894
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20193 Issued in OK
Practice address
3900 E Hillside Dr
Broken Arrow, OK 74014-6713
Phone
(918) 355-1076
NPI assigned
Sep 1, 2023
Last updated
Sep 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20193 OK Primary

Addresses

Primary practice location

3900 E Hillside Dr
Broken Arrow, OK 74014-6713

Mailing address

701 W 101St PL S Apt 428
Jenks, OK 74037-3512
Phone (918) 978-3598

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

LicenseStateTypeSpecialty
20193OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East, LP PastSince Sep 5, 2023 Accepting new patients
Wal-Mart Stores East LP PastSince Sep 5, 2023 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": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1427834894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W 101ST PL S APT 428",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740373512",
            "telephone_number": "918-978-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 E HILLSIDE DR",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740146713",
            "telephone_number": "918-355-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "20193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.