Kacy Layne Jetton, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

2012026452 Issued in MO

Practice address

15425 Manchester Rd
Ballwin, MO 63011-3077

Phone

(636) 256-7922

NPI assigned

Jul 19, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1437635729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15424 MANCHESTER RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113029",
            "telephone_number": "636-256-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15425 MANCHESTER RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113077",
            "telephone_number": "636-256-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETTON",
        "first_name": "KACY",
        "middle_name": "LAYNE",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2012026452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaks Counseling Services
• James H Stanford DDS PC
• Adam David James
• Jensen Health Enterprises
• Anna Lisa Jensen, LPC, NCC
• Lisa Jeziorski
• Jill Baechle Counseling Services
• John Rapp, LCSW, LLC
• Shalece Nicole Johnson, PHARM. D.
• Ashleigh Jones, LPC

• Pharmacist in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.