MS. JACQUELYN KEENAN MARTIN (NPI# 1093095507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093095507 |
| Entity Type | Individual |
| Full Name | MS. JACQUELYN KEENAN MARTIN |
| Credential | R.PH. |
| Practice Address |
1477 W Main St Salem VA 24153-3120 |
| Mailing Address |
Po Box 11780 Blacksburg VA 24062-1780 |
| Practice Telephone | 5403897251 |
| Practice Fax Number | 5403871876 |
| Mailing Telephone | 7046617051 |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2011-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 10804 | NC | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | 006153 | SC | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 0202206150 | VA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528609484 | Jacquelyn Martin | Case Manager/Care Coordinator | 1950 Market St, Riverside, CA 92501-1720 | 2019-10-02 |
| 1083012868 | Jacquelyn Martin | Student in an Organized Health Care Education/Training Program | 1 Brandywine Dr, Deer Park, NY 11729-5721 | 2014-12-10 |
| 1386819373 | Jacquelyn Michelle Martin | Psychiatry & Neurology | 125 Wellness Way, Hot Springs, AR 71913 | 2008-04-29 |
| 1942421672 | Jacquelyn R. Martin | Advanced Practice Midwife | 8350 E Kemper Rd Ste A, Cincinnati, OH 45249-1684 | 2007-05-01 |
| 1659434876 | Jacquelyn Hairston Martin | Nurse Practitioner | 107 Upper Riverdale Rd Sw, Suite B, Riverdale, GA 30274-2540 | 2006-12-19 |
| Street Address |
1477 W MAIN ST |
| City | SALEM |
| State | VA |
| Zip Code | 24153-3120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073538773 | Kroger Limited Partnership I | Pharmacy | 1477 W Main St, Salem, VA 24153-3120 | 2006-07-13 |
| 1538768262 | Tracy Tait | Pharmacist | 1477 W Main St, Salem, VA 24153-3120 | 2020-10-23 |
| 1801198601 | Anita M Brightbill | Pharmacist | 1477 W Main St, Salem, VA 24153-3120 | 2010-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669001228 | Paul Mcguire | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Drive Psychiatry Gme, Salem, VA 24153 | 2020-04-06 |
| 1386114965 | Dynamic Medical LLC | Clinical Medical Laboratory | 1201 Texas Street, Salem, VA 24153 | 2018-11-27 |
| 1134607898 | Renew Psychiatry Services | Psychiatry & Neurology | 177 Electric Rd, Salem, VA 24153 | 2018-08-03 |
| 1508304015 | Samantha Getz | Assisted Living Facility | 3706 Knollridge Rd., Salem, VA 24153 | 2017-02-03 |
| 1518409762 | Melissa Ward | Case Manager/Care Coordinator | 1380 Southside Dr, Suite 100, Salem, VA 24153 | 2016-11-04 |
| 1154729051 | Allison Marie Parry | Physician Assistant | 1336 W Main St., Salem, VA 24153 | 2014-12-09 |
| 1598199457 | Stacy Stanley | Occupational Therapy Assistant | 4812 Moore Rd, Salem, VA 24153 | 2013-08-28 |
| 1366888034 | Dolores Hager | Speech-Language Pathologist | 1851 Harrogate Dr, Salem, VA 24153 | 2013-05-21 |
| 1073850764 | Joel Aaron Nickerson | Specialist/Technologist | 400 Spartan Dr., Salem High School, Salem, VA 24153 | 2013-01-15 |
| 1023387271 | National Diabetic Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 2153 Apperson Drive, Salem, VA 24153 | 2011-12-16 |
| Find all providers in zip 24153 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194356493 | Katherine Janssen | Pharmacist | 875 Oak St Se # 1090, Salem, OR 97301-3975 | 2020-01-27 |
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1982263141 | Darla York | Pharmacist | 502 Highway 62 W, Salem, AR 72576-8400 | 2019-06-11 |
| 1083182372 | Virgil A Guthrie | Pharmacist | 648 Thompson Ave Ne, Salem, OR 97301-2753 | 2018-11-05 |
| 1538645262 | Joo Hyeon Kim | Pharmacist | 3509 Commercial St Se Ste 3507, Salem, OR 97302-3829 | 2018-07-16 |
| 1578086021 | Courtney Parker | Pharmacist | 25 Pelham Rd Ste 104, Salem, NH 03079-4872 | 2017-07-17 |
| 1710359476 | Albert Folsom | Pharmacist | 2757 22nd St Se, Salem, OR 97302-1553 | 2015-10-21 |
| 1558799312 | Tamara Dean Mccollum | Pharmacist | 7 Harbour View Dr, Salem, SC 29676-4513 | 2013-10-14 |
| 1790027431 | Rebecca Cauble Marshall | Pharmacist | #3 Public Square, Salem, IN 47167-9430 | 2013-03-20 |
| 1346587300 | Caitlin Laucka Paarlberg | Pharmacist | 2360 Foxfield Ln, Salem, VA 24153-4740 | 2013-01-10 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.