Active NPI
Jamie Lee Ridley Klucken, PHARMD
- Pharmacist
- Ashburn, VA
National Provider Identifier
1811209489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P6429
- Practice address
- 45085 University Dr
Ashburn, VA 20147-2766 - Phone
- (703) 726-8547
- NPI assigned
- Jul 11, 2010
- 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 | P6429 | ID | Primary |
Addresses
Primary practice location
45085 University Dr
Ashburn, VA 20147-2766
Mailing address
1428 Moore PL SW
Leesburg, VA 20175-5808
Phone (208) 329-0653
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 |
|---|---|---|---|
| P6429 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416355200000",
"number": "1811209489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1428 MOORE PL SW",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201755808",
"telephone_number": "208-329-0653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45085 UNIVERSITY DR",
"city": "ASHBURN",
"state": "VA",
"postal_code": "201472766",
"telephone_number": "703-726-8547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLUCKEN",
"first_name": "JAMIE",
"middle_name": "LEE RIDLEY",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-11",
"last_updated": "2014-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P6429",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashburn, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.