Active NPI
Emera Jackson
- Pharmacist
- Louisa, KY
National Provider Identifier
1790526556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 014217
- Practice address
- 275 Walton Dr
Louisa, KY 41230-9322 - Phone
- (606) 673-4912
- NPI assigned
- Jun 5, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 014217 | KY | Primary |
Addresses
Primary practice location
275 Walton Dr
Louisa, KY 41230-9322
Mailing address
8599 Cedar Hill Estates CT
Ashland, KY 41102-8704
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014217 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients | |
| Wal-Mart Stores East LP | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Walmart Pharmacy 10-4461
- Community/Retail Pharmacy
- Louisa, KY
- NPI 1033318522
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717545600000",
"number": "1790526556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8599 CEDAR HILL ESTATES CT",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411028704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 WALTON DR",
"city": "LOUISA",
"state": "KY",
"postal_code": "412309322",
"telephone_number": "606-673-4912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "EMERA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-05",
"last_updated": "2024-06-05",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "KY",
"license": "014217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisa, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.