Active NPI
Robin Jackson, PHARM. D.
- Ambulatory Care Pharmacist
- Tupelo, MS
National Provider Identifier
1568909893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- E-09982
- Practice address
- 5060 Raymond Avenue
Tupelo, MS 38801-3880 - Phone
- (662) 810-7732
- Fax
- (662) 810-7738
- NPI assigned
- Jan 25, 2017
- Last updated
- Apr 27, 2020
- 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 |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | E-09982 | MS | Primary |
Addresses
Primary practice location
5060 Raymond Avenue
Tupelo, MS 38801-3880
Mailing address
PO Box 1671
Verona, MS 38879-1671
Phone (662) 810-7732
Other practice location 1
2516 Pemberton Ave
Tupelo, MS 38801-4218
Phone (662) 304-0181
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 |
|---|---|---|---|
| E-09982 | MS | MD | Ambulatory Care Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Diabetes Care and Consulting LLC | Current | Accepting new patients | |
| Pakmeds Pharmacy & Consulting, LLC | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Health Service Clinic/Center
- Tupelo, MS
- NPI 1013443811
-
- Community/Retail Pharmacy
- Tupelo, MS
- NPI 1093287369
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587945600000",
"number": "1568909893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1671",
"city": "VERONA",
"state": "MS",
"postal_code": "388791671",
"telephone_number": "662-810-7732",
"fax_number": "662-810-7738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5060 RAYMOND AVENUE",
"city": "TUPELO",
"state": "MS",
"postal_code": "388013880",
"telephone_number": "662-810-7732",
"fax_number": "662-810-7738"
}
],
"practiceLocations": [
{
"address_1": "2516 Pemberton Ave",
"address_purpose": "LOCATION",
"city": "Tupelo",
"state": "MS",
"postal_code": "388014218",
"country_code": "US",
"telephone_number": "662-304-0181",
"fax_number": "662-346-4551",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "ROBIN",
"credential": "PHARM. D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-25",
"last_updated": "2020-04-27",
"certification_date": "2020-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "MS",
"license": "E-09982",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.