Courtney Jackson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

43613 Issued in SC

Practice address

1903 S Lake Dr
Lexington, SC 29073-7760

Phone

(803) 356-1001

NPI assigned

Dec 9, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Locations

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.

• Walgreen Co

  • Pharmacy
  • Lexington, SC
  • NPI 1356510820
  NPD
• Walgreen Co

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

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1679284731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 SAINT GEORGE RD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291702880",
            "telephone_number": "803-341-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 S LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290737760",
            "telephone_number": "803-356-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "COURTNEY",
        "name_prefix": "Ms.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "43613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isd Renal Inc
• Jean T Isherwood, WHNP-BC
• Sylvia Goodman Iwenofu, PA
• Alice Jackson, PT
• April Michelle Jackson
• Gwennetta Patrice Jackson, COTA
• James Benjamin Jackson III, MD
• Jessica M Jackson, PT
• Richard Edwin Jackson, DMD
• Ronald Jackson, MSW

• Pharmacist in Lexington, SC
• Providers in Lexington, SC by specialty
• Pharmacist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.