Jason Lawrence Walck, PHARM.D.

Primary specialty

Geriatric PharmacistTaxonomy code 1835G0303X

License

9103911 Issued in WY

Practice address

2360 E Pershing Blvd # 119
Cheyenne, WY 82001-5356

Phone

(307) 778-7550

NPI assigned

Jul 14, 2011

Last updated

Jan 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

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.

• Buffalo Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Buffalo, NY
  • NPI 1740238252
  NPD (past)

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1700174539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 EAST PERSHING BLVD",
            "address_2": "PHARMACY 119",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "82001",
            "telephone_number": "307-778-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 E PERSHING BLVD # 119",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015356",
            "telephone_number": "307-778-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALCK",
        "first_name": "JASON",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "054562",
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "WY",
            "license": "9103911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan M Wagnon, PHARMACIST
• Brock Wahlert
• Danielle Wakelin, OTR/L
• Wal-Mart Srores Inc (Walmart Vision Center 30-4653)
• Wal-Mart Stores, Inc. (Vision Center 30-1315)
• Karla D Walden, M.S, R.D.
• Jacqueline K Waldo
• Lewis Page Waldron Jr., LAT
• Walgreen Co (Walgreens #09548)
• Walgreen Co (Walgreens #05838)

• Geriatric Pharmacist in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Geriatric Pharmacist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.