Active NPI
Jermaine Eka, PHARM D
- Pharmacist
- Fayetteville, AR
National Provider Identifier
1649977208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD16075
- Practice address
- 4007 N Shiloh Dr
Fayetteville, AR 72703-5300 - Phone
- (479) 442-4756
- NPI assigned
- Feb 13, 2023
- Last updated
- Feb 13, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | PD16075 | AR | Primary |
Addresses
Primary practice location
4007 N Shiloh Dr
Fayetteville, AR 72703-5300
Mailing address
2909 N 14TH St
Rogers, AR 72756-2632
Other practice location 1
524 S School Ave
Fayetteville, AR 72701-5957
Phone (479) 251-7685
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 |
|---|---|---|---|
| PD16075 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1649977208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2909 N 14TH ST",
"city": "ROGERS",
"state": "AR",
"postal_code": "727562632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4007 N SHILOH DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727035300",
"telephone_number": "479-442-4756"
}
],
"practiceLocations": [
{
"address_1": "524 S School Ave",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "AR",
"postal_code": "727015957",
"country_code": "US",
"telephone_number": "479-251-7685",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EKA",
"first_name": "JERMAINE",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-13",
"last_updated": "2023-02-13",
"certification_date": "2023-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD16075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.