Active NPI
Jacklyn Louise Patton, PHARMD
- Pharmacist
- Beaver, PA
National Provider Identifier
1841900271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP459007
- Practice address
- 246 Friendship Cir
Beaver, PA 15009-9704 - Phone
- (724) 512-8767
- NPI assigned
- Nov 28, 2022
- Last updated
- Oct 13, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP459007 | PA | Primary |
| Intermediate Emergency Medical Technician | 146M00000X | 0890773 | PA |
Addresses
Primary practice location
246 Friendship Cir
Beaver, PA 15009-9704
Mailing address
246 Friendship Cir
Beaver, PA 15009-9704
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 |
|---|---|---|---|
| 0890773 | PA | MD | Intermediate Emergency Medical Technician |
| RP459007 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co. | Past | Accepting new patients | |
| Walgreen Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728777600000",
"number": "1841900271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "246 FRIENDSHIP CIR",
"city": "BEAVER",
"state": "PA",
"postal_code": "150099704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "246 FRIENDSHIP CIR",
"city": "BEAVER",
"state": "PA",
"postal_code": "150099704",
"telephone_number": "724-512-8767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTON",
"first_name": "JACKLYN",
"middle_name": "LOUISE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-28",
"last_updated": "2024-10-13",
"certification_date": "2024-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP459007",
"primary": true
},
{
"code": "146M00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Intermediate",
"state": "PA",
"license": "0890773",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaver, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.