Active NPI
David Kenneth Jackson, RPH.
- Pharmacist
- King of Prussia, PA
National Provider Identifier
1649592601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP438113
- Practice address
- 625 Clark Avenue
Suite 16
King of Prussia, PA 19406 - Phone
- (610) 491-9700
- Fax
- (610) 354-0800
- NPI assigned
- Feb 18, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP438113 | PA | Primary |
Addresses
Primary practice location
625 Clark Avenue
Suite 16
King of Prussia, PA 19406
Mailing address
625 Clark Avenue
Suite 16
King of Prussia, PA 19406
Phone (610) 491-9700
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP438113 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266451200000",
"number": "1649592601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 CLARK AVENUE",
"address_2": "SUITE 16",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "19406",
"telephone_number": "610-491-9700",
"fax_number": "610-354-0800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 CLARK AVENUE",
"address_2": "SUITE 16",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "19406",
"telephone_number": "610-491-9700",
"fax_number": "610-354-0800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DAVID",
"middle_name": "KENNETH",
"credential": "RPH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-18",
"last_updated": "2010-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP438113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in King of Prussia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.