Jessica Ellen Tucker, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

T10175 Issued in MS

Practice address

1628 Simpson Highway 49
Magee, MS 39111-4294

Phone

(601) 849-4959

Fax

(601) 849-6645

NPI assigned

Dec 1, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Jessica Ellen Stevens Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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
  • Magee, MS
  • NPI 1295925428
  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": "1322697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1891063178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 SIMPSON HIGHWAY 49",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391114294",
            "telephone_number": "601-849-4959",
            "fax_number": "601-849-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 SIMPSON HIGHWAY 49",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391114294",
            "telephone_number": "601-849-4959",
            "fax_number": "601-849-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JESSICA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "T10175",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "17227",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "STEVENS",
            "middle_name": "ELLEN",
            "prefix": "DR.",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Madeline Klaire Sullivan, DPT
• Stacie Sullivan, PHARMD
• The Pedz Clinic
• Thomas R. Blackledge, Jr., MD, PA
• Summer Thomas, OTR/L
• Venture Hospitalist, LLC
• Frank C Wade Jr., M.D.
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co

• Pharmacist in Magee, MS
• Providers in Magee, MS by specialty
• Pharmacist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.