Jaclyn Marie Carr, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

2014006413 Issued in MO

Practice address

4140 S Broadway
Saint Louis, MO 63118-4604

Phone

(314) 832-4995

Fax

(314) 832-6636

NPI assigned

Aug 24, 2020

Last updated

Aug 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Walgreen Co

  dba Walgreens #03686

  • Pharmacy
  • Saint Louis, MO
  • NPI 1740295989
  NPD (past)
• Walgreen Co

  dba Walgreens #21605

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1649883380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2227 JULES ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631042715",
            "telephone_number": "618-910-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 S BROADWAY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631184604",
            "telephone_number": "314-832-4995",
            "fax_number": "314-832-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051296928",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2014006413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "rxm.03686@store.walgreens.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4140 S Broadway",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631184604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Barbara A Carr, PNP
• Brittney Carr
• Christopher D Carr, CHW-C, DOULA
• David B Carr, MD
• De'Sha Anne' Carr
• Kathryn Carr
• Kelly B Carr
• Kimberly Carr, REGISTERED NURSE
• Larhonda D Carr
• Nicole Denise Carr, RN, BSN, MSN, FNP-BC

• Pharmacist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.

Verify at the official NPI Registry.