Active NPI
Vikki Lynn Jacob, R.PH.
- Pharmacist
- Hixson, TN
National Provider Identifier
1780937276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8008
- Practice address
- 5380 Highway 153
Hixson, TN 37343-4946 - Phone
- (423) 870-8562
- NPI assigned
- Oct 21, 2012
- 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 | 183500000X | 8008 | TN | Primary |
Addresses
Primary practice location
5380 Highway 153
Hixson, TN 37343-4946
Mailing address
3630 Willow Oak Cir NW
Cleveland, TN 37312-1748
Phone (423) 476-2512
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8008 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350777600000",
"number": "1780937276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3630 WILLOW OAK CIR NW",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373121748",
"telephone_number": "423-476-2512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5380 HIGHWAY 153",
"city": "HIXSON",
"state": "TN",
"postal_code": "373434946",
"telephone_number": "423-870-8562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "VIKKI",
"middle_name": "LYNN",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-21",
"last_updated": "2012-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "8008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hixson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.