Individual provider Active NPI

Jennifer Shaina Davis

  • Pharmacist
  • Lexington, KY
National Provider Identifier
1902434285
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
021004 Issued in KY
Practice address
110 Towne Center Dr
Lexington, KY 40511-2027
Phone
(859) 288-2172
NPI assigned
Mar 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 021004 KY Primary

Addresses

Primary practice location

110 Towne Center Dr
Lexington, KY 40511-2027

Mailing address

110 Towne Center Dr
Lexington, KY 40511-2027

Other identifiers 1

IdentifierTypeStateIssuer
361924025OtherKY361924025

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL walgreens.com WALGREENS

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

State licenses

LicenseStateTypeSpecialty
021004KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Apr 5, 2020 Accepting new patients

Organizations & group practices 1

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1902434285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 TOWNE CENTER DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405112027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 TOWNE CENTER DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405112027",
            "telephone_number": "859-288-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JENNIFER",
        "middle_name": "SHAINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2023-11-27",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "021004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "361924025",
            "identifier": "361924025",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "walgreens.com",
            "affiliation": "Y",
            "affiliationName": "WALGREENS",
            "address_1": "110 Towne Center Dr",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405112027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.