Teresa B. Jackson, RPH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

07539 Issued in NC

Practice address

Lower Level Reynolds Gym Wingate Road
Lower Level Reynolds Gym Wingate Road
Winston-Salem, NC 27109

Phone

(336) 758-5218

Fax

(336) 758-6054

NPI assigned

Apr 20, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831317528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 GREENHILL DR",
            "city": "PFAFFTOWN",
            "state": "NC",
            "postal_code": "270409557",
            "telephone_number": "336-758-5218",
            "fax_number": "336-758-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LOWER LEVEL REYNOLDS GYM WINGATE ROAD",
            "address_2": "LOWER LEVEL REYNOLDS GYM WINGATE ROAD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27109",
            "telephone_number": "336-758-5218",
            "fax_number": "336-758-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TERESA",
        "middle_name": "B.",
        "name_prefix": "Mrs.",
        "credential": "RPH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "07539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary P Jackson, LCSWA
• Megan Ezelle Jackson, CRNA
• Richard Dewitt Jackson II, M.D.
• Shermeca Kyhana Jackson, PT
• Staci Tate Jackson, SLP
• Tommie S. Jackson
• Toni Beth Jackson, PA-C
• Travis Harold Jackson, MD
• Vivian Sapphira Jackson
• Jacob Brotzman DMD PLLC (Restoration Dental)

• Pharmacist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Pharmacist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.