Active NPI
Jaclyn S. Gavin, RPH, PHARMD, BCPS
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Hopkinsville, KY
National Provider Identifier
1699174441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 2014021643
- Practice address
- 1002 S Virginia St
Hopkinsville, KY 42240-3507 - Phone
- (270) 885-2106
- NPI assigned
- Aug 18, 2014
- 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 2014021643 | MO | Primary |
Addresses
Primary practice location
1002 S Virginia St
Hopkinsville, KY 42240-3507
Mailing address
1310 24TH Ave S
Nashville, TN 37212-2637
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014021643 | MO | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538438400000",
"number": "1699174441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 24TH AVE S",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372122637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 S VIRGINIA ST",
"city": "HOPKINSVILLE",
"state": "KY",
"postal_code": "422403507",
"telephone_number": "270-885-2106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVIN",
"first_name": "JACLYN",
"middle_name": "S.",
"credential": "RPH, PHARMD, BCPS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-18",
"last_updated": "2018-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MO",
"license": "2014021643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hopkinsville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.