Active NPI
Jessica Disselkamp, PHARMD
- Pharmacist
- Shepherdsville, KY
National Provider Identifier
1467866855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 016225
- Practice address
- 445 Highway 44 E
Shepherdsville, KY 40165-6020 - Phone
- (502) 543-2355
- NPI assigned
- Jun 13, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 016225 | KY | Primary |
Addresses
Primary practice location
445 Highway 44 E
Shepherdsville, KY 40165-6020
Mailing address
540 Shipley Rd
Cecilia, KY 42724-8716
Phone (270) 300-6493
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
| License | State | Type | Specialty |
|---|---|---|---|
| 016225 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402617600000",
"number": "1467866855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 SHIPLEY RD",
"city": "CECILIA",
"state": "KY",
"postal_code": "427248716",
"telephone_number": "270-300-6493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 HIGHWAY 44 E",
"city": "SHEPHERDSVILLE",
"state": "KY",
"postal_code": "401656020",
"telephone_number": "502-543-2355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISSELKAMP",
"first_name": "JESSICA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-13",
"last_updated": "2014-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "016225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shepherdsville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.