Individual provider Active NPI

Materra Cotton Comer, PHARMD

  • Pharmacist
  • Jackson, MS
National Provider Identifier
1437380607
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E-09747 Issued in MS
Practice address
2496 N Cheryl Dr
Jackson, MS 39211-4907
Phone
(601) 946-5353
NPI assigned
Aug 5, 2009
Last updated
Aug 5, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E-09747 MS Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X E-09747 MS

Addresses

Primary practice location

2496 N Cheryl Dr
Jackson, MS 39211-4907

Mailing address

2496 N Cheryl Dr
Jackson, MS 39211-4907
Phone (601) 946-5353

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
E-09747MSMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249430400000",
    "number": "1437380607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2496 N CHERYL DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114907",
            "telephone_number": "601-946-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2496 N CHERYL DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114907",
            "telephone_number": "601-946-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMER",
        "first_name": "MATERRA",
        "middle_name": "COTTON",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-05",
        "last_updated": "2009-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-09747",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MS",
            "license": "E-09747",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; 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.