Caitlin Raeann Jackson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

021952 Issued in KY

Practice address

1000 S 12TH St
Murray, KY 42071-9303

Phone

(270) 767-6960

NPI assigned

Jan 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1831840198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 E WOOD ST",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382429630",
            "telephone_number": "931-436-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S 12TH ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420719303",
            "telephone_number": "270-767-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CAITLIN",
        "middle_name": "RAEANN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "44557",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "021952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "1000 S 12th St",
            "city": "Murray",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420719303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hannah Mathis Hutson, PA-C
• Imac Medical of Kentucky PSC
• Intensive Care Experts Health Network LLC
• Cynthia S Ivey, CSFA
• J David Outland, M.D.
• Herschel S Jackson Jr., M.D.
• Leanna Marie Jackson, APRN
• James David Jaco, O.D.
• Alycia Christine Janow
• Jarvis Vision Center, PLLC

• Pharmacist in Murray, KY
• Providers in Murray, KY by specialty
• Pharmacist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.