Jeffrey Scott Jackson

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

06268 Issued in NC

Legal business name

JEFFREY SCOTT JACKSON

Practice address

16821 Rosman Hwy
Lake Toxaway, NC 28747-9593

Phone

(828) 884-3784

Fax

(828) 884-3792

NPI assigned

Dec 26, 2006

Organization subpart

No

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

Authorized official

Name

Jeffrey Jackson, RPHNPI 1760589477

Title

Owner

Phone

(828) 884-3784

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• TOXAWAY PHARMACY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Scott Jackson

  • Pharmacist
  • Lake Toxaway, NC
  • NPI 1760589477
  NPD (past) Authorized official

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327017600000",
    "number": "1932264355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16821 ROSMAN HWY",
            "city": "LAKE TOXAWAY",
            "state": "NC",
            "postal_code": "287479593",
            "telephone_number": "828-884-3784",
            "fax_number": "828-884-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16821 ROSMAN HWY",
            "city": "LAKE TOXAWAY",
            "state": "NC",
            "postal_code": "287479593",
            "telephone_number": "828-884-3784",
            "fax_number": "828-884-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY SCOTT JACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2012-01-20",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-884-3784",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "06268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0885202A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3432933",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TOXAWAY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erin R Cantalini
• Vicky Leigh Cooke-Thornton, ANP-C
• James Todd Green
• Jeffrey Scott Jackson
• Sarah James, MA, LCMHC, LCAS
• Carla Rebecca Kimmel, FNP-C
• Leah Subalusky Madamba, MS, NCC, LCMHC
• Justin Messinger, LCMHC
• William Noran, MD
• Mary Shalene Pierce, MSW, LCSW

• All providers in Lake Toxaway, NC
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.