Jennefer L Davis, RPH, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

051299244 Issued in IL

Practice address

3100 11TH St
Rock Island, IL 61201-6706

Phone

(309) 786-4312

Fax

(309) 786-1619

NPI assigned

Sep 3, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Rock Island, IL
  • NPI 1164437380
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1861006041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 11TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612016706",
            "telephone_number": "309-786-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 11TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612016706",
            "telephone_number": "309-786-4312",
            "fax_number": "309-786-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JENNEFER",
        "middle_name": "L",
        "credential": "RPH, PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "22569",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051299244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretta Jo Anne Dalton, PHARMD
• Tuan Minh Dang
• Rebecca Dardon
• David Benjamin Kaplan PLLC
• Melissa Brooke Davidson, MSW
• Olivia Deardoff
• Carol Debrackeleire, M.A.
• Kaitlynn Mae Decker
• Haley Deering
• Andrew Clark Defrees

• Pharmacist in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.