Erin Doraine Jackson, PHARMD, CDM

Primary specialty

PharmacistTaxonomy code 183500000X

License

P5601 Issued in ID

Practice address

1620 N Whitley Dr
Fruitland, ID 83619-2129

Phone

(208) 452-7075

Fax

(208) 452-7446

NPI assigned

Oct 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

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

Locations

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.

• Ontario Pharmacy Inc

  • Community/Retail Pharmacy
  • Fruitland, ID
  • NPI 1760564553
  NPD (past) Authorized official
• Prescription Pad LLC

  • Community/Retail Pharmacy
  • Fruitland, ID
  • NPI 1891102653
  NPD

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1447448154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 NW 16TH ST # 150",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192271",
            "telephone_number": "208-452-7075",
            "fax_number": "208-452-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 N WHITLEY DR",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192129",
            "telephone_number": "208-452-7075",
            "fax_number": "208-452-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ERIN",
        "middle_name": "DORAINE",
        "name_prefix": "Mrs.",
        "credential": "PHARMD, CDM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "16162",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0011841",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "9031849-1701",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Irons, FNP
• Victor M Ishida, P.A.
• Issc Fruitland
• Iwasa Eye Center P.a.
• J Alan Timmons DDS PC
• Sheila Diane Jacobs, MPT
• Mary Lynn James, PA
• Jangula Cox Counseling LLC
• JC2 Enterprises LLC
• Trenton John Jenks, PHARM. D, CGP

• Pharmacist in Fruitland, ID
• Providers in Fruitland, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.