Active NPI
Breanna Renee Jackson, PHARMD
- Ambulatory Care Pharmacist
- Corbin, KY
National Provider Identifier
1700736071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 023594
- Practice address
- 1 Trillium Way
Corbin, KY 40701-8426 - Phone
- (606) 526-4647
- NPI assigned
- Jan 28, 2026
- 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 |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 023594 | KY | Primary |
Addresses
Primary practice location
1 Trillium Way
Corbin, KY 40701-8426
Mailing address
1 Trillium Way
Corbin, KY 40701-8426
Phone (606) 526-4888
Other practice location 1
1406 W 5th St
London, KY 40741-1688
Phone (606) 526-4888
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
| License | State | Type | Specialty |
|---|---|---|---|
| 023594 | KY | MD | Ambulatory Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1769558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769558400000",
"number": "1700736071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 TRILLIUM WAY",
"city": "CORBIN",
"state": "KY",
"postal_code": "407018426",
"telephone_number": "606-526-4888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 TRILLIUM WAY",
"city": "CORBIN",
"state": "KY",
"postal_code": "407018426",
"telephone_number": "606-526-4647"
}
],
"practiceLocations": [
{
"address_1": "1406 W 5th St",
"address_purpose": "LOCATION",
"city": "London",
"state": "KY",
"postal_code": "407411688",
"country_code": "US",
"telephone_number": "606-526-4888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "BREANNA",
"middle_name": "RENEE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-01-28",
"last_updated": "2026-01-28",
"certification_date": "2026-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "KY",
"license": "023594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corbin, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.