Active NPI
M Jacklynn Estes, RPH
- Pharmacist
- Williston, VT
National Provider Identifier
1992829097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3178
- Practice address
- 108 Cornerstone Dr
Williston, VT 05495-4034 - Phone
- (802) 878-1118
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- 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 | 3178 | VT | Primary |
Addresses
Primary practice location
108 Cornerstone Dr
Williston, VT 05495-4034
Mailing address
317 Old Farm Rd
Richmond, VT 05477-9236
Phone (802) 434-5288
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3178 | Other | VT | STACE LICENSE |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3178 | VT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992829097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 OLD FARM RD",
"city": "RICHMOND",
"state": "VT",
"postal_code": "054779236",
"telephone_number": "802-434-5288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 CORNERSTONE DR",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054954034",
"telephone_number": "802-878-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTES",
"first_name": "M",
"middle_name": "JACKLYNN",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VT",
"license": "3178",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STACE LICENSE",
"identifier": "3178",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williston, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.