Active NPI
Jay Vansickle, PHARMD
- Pharmacist
- Clinton, TN
National Provider Identifier
1871104620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 43678
- Practice address
- 2151 N Charles G Seivers Blvd
Clinton, TN 37716-6749 - Phone
- (865) 457-1377
- NPI assigned
- Aug 14, 2020
- Sex
- Male
- 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 | 43678 | TN | Primary |
Addresses
Primary practice location
2151 N Charles G Seivers Blvd
Clinton, TN 37716-6749
Mailing address
2151 N Charles G Seivers Blvd
Clinton, TN 37716-6749
Phone (865) 457-1377
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 |
|---|---|---|---|
| 43678 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
2151 N Charles G Seivers Blvd
Clinton, TN 37716
Phone (865) 457-1377
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597363200000",
"number": "1871104620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2151 N CHARLES G SEIVERS BLVD",
"city": "CLINTON",
"state": "TN",
"postal_code": "377166749",
"telephone_number": "865-457-1377",
"fax_number": "865-457-1327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2151 N CHARLES G SEIVERS BLVD",
"city": "CLINTON",
"state": "TN",
"postal_code": "377166749",
"telephone_number": "865-457-1377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANSICKLE",
"first_name": "JAY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-14",
"last_updated": "2020-08-14",
"certification_date": "2020-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "43678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, TN
- Christina Trezza-Horn, LCSW
- Uhs Primary Care LLC (UT Family Physicians Clinton)
- Alison J Ulino, PT, DPT
- Vickie Underwood, RN
- University Health System, Inc (UT Family Physicians Clinton)
- Erika Vibbert, RN
- Colin Michael Vican
- Amy Victor
- Brenda Joanne Vowell, R.N.
- Wal-Mart Stores East LP (Walmart Pharmacy 10-4635)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.