NPIMap

Individual provider Active NPI

Jeff Jackson, PHARMD

  • Pharmacist
  • Richmond, KY
National Provider Identifier
1497171599
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
011557 Issued in KY
Practice address
2013 Lantern Ridge Dr
Richmond, KY 40475-6010
Phone
(859) 575-5033
Fax
(859) 575-5065
NPI assigned
Mar 13, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 011557 KY Primary

Addresses

Primary practice location

2013 Lantern Ridge Dr
Richmond, KY 40475-6010

Mailing address

2013 Lantern Ridge Dr
Richmond, KY 40475-6010
Phone (859) 575-5033

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
011557KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Meijer Great Lakes Limited Partnership Past Accepting new patients
Meijer Great Lakes Limited Partnership Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1497171599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 LANTERN RIDGE DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404756010",
            "telephone_number": "859-575-5033",
            "fax_number": "859-575-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 LANTERN RIDGE DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404756010",
            "telephone_number": "859-575-5033",
            "fax_number": "859-575-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JEFF",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-13",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "011557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

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

Verify at the official NPI Registry.