Individual provider Active NPI

Jakeia Smith, PHARMD

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1669184156
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
31766 Issued in NC
Practice address
3534 Mt Holly Huntersville Rd
Charlotte, NC 28216-8644
Phone
(704) 399-5823
NPI assigned
Dec 16, 2022
Last updated
Dec 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 31766 NC Primary

Addresses

Primary practice location

3534 Mt Holly Huntersville Rd
Charlotte, NC 28216-8644

Mailing address

7035 Primrose Gardens LN Apt 3103
Charlotte, NC 28273-4473
Phone (601) 317-4445

Other practice location 1

3251 Freedom Dr
Charlotte, NC 28208-2816
Phone (704) 399-3955

Other identifiers 1

IdentifierTypeStateIssuer
1447335765OtherNCWALGREENS

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

LicenseStateTypeSpecialty
31766NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Dec 1, 2022 Accepting new patients
Walgreen Co PastSince Dec 1, 2022 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, 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": "1671148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1669184156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7035 PRIMROSE GARDENS LN APT 3103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282734473",
            "telephone_number": "601-317-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3534 MT HOLLY HUNTERSVILLE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282168644",
            "telephone_number": "704-399-5823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3251 Freedom Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282082816",
            "country_code": "US",
            "telephone_number": "704-399-3955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAKEIA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-16",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "31766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WALGREENS",
            "identifier": "1447335765",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.