Active NPI
Pam J Jackson, RPH
- Pharmacist
- Oak Grove, MO
National Provider Identifier
1659555290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2002008454
- Practice address
- 300 SE Salem St
Oak Grove, MO 64075-9299 - Phone
- (816) 690-8600
- Fax
- (816) 625-8160
- NPI assigned
- Dec 18, 2007
- Last updated
- Dec 18, 2007
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2002008454 | MO | Primary |
Addresses
Primary practice location
300 SE Salem St
Oak Grove, MO 64075-9299
Mailing address
300 SE Salem St
Oak Grove, MO 64075-9299
Phone (816) 690-8600
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 |
|---|---|---|---|
| 2002008454 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197936000000",
"number": "1659555290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 SE SALEM ST",
"city": "OAK GROVE",
"state": "MO",
"postal_code": "640759299",
"telephone_number": "816-690-8600",
"fax_number": "816-625-8160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SE SALEM ST",
"city": "OAK GROVE",
"state": "MO",
"postal_code": "640759299",
"telephone_number": "816-690-8600",
"fax_number": "816-625-8160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "PAM",
"middle_name": "J",
"name_prefix": "Miss",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-18",
"last_updated": "2007-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2002008454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Grove, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.