Steven L Jackson, Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

1200 Issued in FL

Legal business name

STEVEN L JACKSON, INC

Practice address

2256 W Nine Mile Rd
Pensacola, FL 32534

Phone

(850) 478-4450

Fax

(850) 478-4842

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Steven L Jackson, R. PHNPI 1912906736

Title

Owner

Phone

(850) 478-4450

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jackson-Pace Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven L Jackson, R.PH.

  • Pharmacist
  • Pensacola, FL
  • NPI 1912906736
  NPD Authorized official
• Kenneth Alan Fredriksson, PHARMD

  • Pharmacist
  • Pensacola, FL
  • NPI 1013211549
  NPD (past)
• Alexander Bishop Jackson, PHARM.D.

  • Pharmacist
  • Pensacola, FL
  • NPI 1235767724
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531267200000",
    "number": "1770591968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2256 W NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325349415",
            "telephone_number": "850-478-4450",
            "fax_number": "850-478-4842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2256 W NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32534",
            "telephone_number": "850-478-4450",
            "fax_number": "850-478-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN L JACKSON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2018-07-11",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-478-4450",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R. PH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "1200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010361-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson-Pace Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jackson-Pace Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stern Family Chiropractic, LLC
• Jason Eric Stern, D.C.
• Danielle Carroll Sterner, MS,RD
• Leif Erik Sternung, APRN
• Steve Hirschorn, PH.D.
• Carollynn Stevens, ATC, LAT
• Rick Brian Stevens, MD
• Tyler Russell Steverson
• Abigail Stewart, MD
• Angela Stewart, APRN

• Pharmacist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.