NPIMap

Individual provider Active NPI

Carrie A Jackman, PHARMD

  • Pharmacist
  • Twin Falls, ID
National Provider Identifier
1932484334
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P5344 Issued in ID
Practice address
1913 Addison Ave E
Twin Falls, ID 83301-5305
Phone
(208) 734-4581
Fax
(208) 736-7144
NPI assigned
Oct 17, 2011
Last updated
Oct 17, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P5344 ID Primary

Addresses

Primary practice location

1913 Addison Ave E
Twin Falls, ID 83301-5305

Mailing address

1913 Addison Ave E
Twin Falls, ID 83301-5305
Phone (208) 734-4581

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

LicenseStateTypeSpecialty
P5344IDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Smiths Food & Drug Centers Inc Past Accepting new patients
Smith's Food & Drug Centers Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1932484334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 ADDISON AVE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015305",
            "telephone_number": "208-734-4581",
            "fax_number": "208-736-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 ADDISON AVE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015305",
            "telephone_number": "208-734-4581",
            "fax_number": "208-736-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKMAN",
        "first_name": "CARRIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.