James Eddlemon

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

07251 Issued in MS

Practice address

465 Stateline Rd W
Southaven, MS 38671-1611

Phone

(662) 393-3426

NPI assigned

Dec 17, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • Southaven, MS
  • NPI 1275567042
  NPD (past)
• Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • Newport, KY
  • NPI 1104791078
  NPD (past)

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1720626161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8814 BEATLINE RD",
            "city": "TUNICA",
            "state": "MS",
            "postal_code": "386769603",
            "telephone_number": "901-568-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 STATELINE RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711611",
            "telephone_number": "662-393-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDLEMON",
        "first_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-17",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "07251",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MS",
            "license": "07251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720626161",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Charles Eakins Jr., O.D.
• Alexandra Eames, M.A., CCC-SLP
• Ease of Mind Counseling LLC
• Haley Eastman
• Nadir Asraf Ebrahim
• Shelby Elisa Whitsell Edmonds, M.S., CCC-SLP
• Raven Simone Edwards
• Christy Le Anne Egbert, FNP
• Vania Chinwe Ejiofor, MD
• Samir Eldahan, DDS

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Southaven, MS
• Providers in Southaven, MS by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.

Verify at the official NPI Registry.