Active NPI
Joseph Jackson
- Pharmacy Technician
- Rockville, MD
National Provider Identifier
1619834736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- T30575
- Practice address
- 625 Hungerford Dr
Rockville, MD 20850-1721 - Phone
- (240) 314-5161
- NPI assigned
- Jan 9, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | T30575 | MD | |
| Pharmacy Technician | 183700000X | T30575 | MD | Primary |
Addresses
Primary practice location
625 Hungerford Dr
Rockville, MD 20850-1721
Mailing address
625 Hungerford Dr
Rockville, MD 20850-1721
Phone (240) 314-5161
Other names 1
- Mr. Joey Yasuda-Jackson
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T30575 | MD | MD | Other Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Giant of Maryland LLC | Past | Accepting new patients | |
| Giant of Maryland LLC | 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.
-
- Community/Retail Pharmacy
- Rockville, MD
- NPI 1023043080
-
- Community/Retail Pharmacy
- Parkville, MD
- NPI 1639938020
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1767916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769385600000",
"number": "1619834736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 HUNGERFORD DR",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208501721",
"telephone_number": "240-314-5161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 HUNGERFORD DR",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208501721",
"telephone_number": "240-314-5161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JOSEPH",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-01-09",
"last_updated": "2026-01-26",
"certification_date": "2026-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "MD",
"license": "T30575",
"primary": false
},
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "MD",
"license": "T30575",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JOEY",
"last_name": "YASUDA-JACKSON",
"prefix": "MR.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.