Active NPI
Jessalyn Elise Tackett
- Pharmacist
- Searcy, AR
National Provider Identifier
1679188874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD15088
- Practice address
- 200 E. Race Ave
Searcy, AR 72143 - Phone
- (501) 279-1125
- Fax
- (501) 279-1334
- NPI assigned
- Sep 14, 2020
- 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 | PD15088 | AR | Primary |
Addresses
Primary practice location
200 E. Race Ave
Searcy, AR 72143
Mailing address
200 E. Race Ave
Searcy, AR 72143
Phone (501) 279-1125
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD15088 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
200 E Race Ave
Searcy, AR 72143
Phone (501) 279-1125
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600041600000",
"number": "1679188874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E. RACE AVE",
"city": "SEARCY",
"state": "AR",
"postal_code": "72143",
"telephone_number": "501-279-1125",
"fax_number": "501-279-1334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E. RACE AVE",
"city": "SEARCY",
"state": "AR",
"postal_code": "72143",
"telephone_number": "501-279-1125",
"fax_number": "501-279-1334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TACKETT",
"first_name": "JESSALYN",
"middle_name": "ELISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-14",
"last_updated": "2020-09-14",
"certification_date": "2020-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD15088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Searcy, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.