DR. RICKY ADONIS JACKSON (NPI# 1225413560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225413560 |
| Entity Type | Individual |
| Full Name | DR. RICKY ADONIS JACKSON |
| Credential | PHARM.D. |
| Practice Address |
510 Kings Hwy Shreveport LA 71104-4444 |
| Practice Telephone | 3184240896 |
| Mailing Telephone | 3184240896 |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 021137 | LA | Pharmacy Service Providers |
| Street Address |
510 KINGS HWY |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71104-4444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861565335 | Brookshire Grocery Company | Pharmacy | 510 Kings Hwy, Attention Pharmacy Dept, Shreveport, LA 71104-4444 | 2006-11-15 |
| 1730630682 | Stephanie Hatten | Pharmacist | 510 Kings Hwy, Shreveport, LA 71104-4444 | 2016-10-16 |
| 1962768069 | Thomas Raymond Campbell | Pharmacist | 510 Kings Hwy, Shreveport, LA 71104-4444 | 2012-04-03 |
| 1104133347 | Elizabeth Mccormick | Pharmacist | 510 Kings Hwy, Shreveport, LA 71104-4444 | 2010-09-09 |
| 1740439751 | Larry Leon Chretien | Pharmacist | 510 Kings Hwy, Shreveport, LA 71104-4444 | 2008-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326582263 | Dana Jackson | Counselor | 2425 Youree Drive, Shreveport, LA 71104 | 2016-12-12 |
| 1154772929 | Belena Cawthorne | Case Manager/Care Coordinator | 2040 Southern Ave, Shreveport, LA 71104 | 2016-06-23 |
| 1437505286 | Courtney Espenan | Counselor | 3825 Gilbert Dr Ste 124, Shreveport, LA 71104 | 2016-05-11 |
| 1215390497 | Joshua Mitchell | Counselor | 1106 Dalzell Street, Shreveport, LA 71104 | 2016-04-04 |
| 1699135426 | Amy Lutricia Krohn | Counselor | 1041 Dalzell St, Shreveport, LA 71104 | 2016-03-07 |
| 1225497779 | Annie Redding II | Counselor | 2525 Youree Dr Suite 110, Shreveport, LA 71104 | 2016-02-12 |
| 1891152328 | Council On Alcoholism and Drug Abuse of Northwest Louisiana | Community/Behavioral Health | 2000 Fairfield Ave, Shreveport, LA 71104 | 2016-01-28 |
| 1922465731 | Marteze Singleton | Case Manager/Care Coordinator | 2525 Youree Dr Ste 10, Shreveport, LA 71104 | 2016-01-25 |
| 1891160297 | Damara Mora | Counselor | 2620 Centenary Blvd Bldg3 Ste 312, Shreveport, LA 71104 | 2015-12-10 |
| 1962876250 | Chastity Shermaine Graham | Counselor | 2620 Centenary Blvd Ste 312, Shreveport, LA 71104 | 2015-11-24 |
| Find all providers in zip 71104 | ||||
| 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 |
|---|---|---|---|---|
| 1982211397 | Bradford Louis Morgan | Pharmacist | 9084 Ferry Creek Dr, Shreveport, LA 71106-8404 | 2020-09-29 |
| 1306453451 | Benjamin Allbritton | Pharmacist | 1333 Coates Bluff Dr Apt 1324, Shreveport, LA 71104-2823 | 2020-09-23 |
| 1760031652 | Cecelia Vergo | Pharmacist | 388 Bert Kouns Industrial Loop, Shreveport, LA 71106-8123 | 2019-09-04 |
| 1700431244 | Jennifer S Boudreaux | Pharmacist | 1410 Kings Hwy, Shreveport, LA 71103-4227 | 2019-08-01 |
| 1932688702 | Cortez Davis | Pharmacist | 6000 W 70th St Apt 1107, Shreveport, LA 71129-2530 | 2018-08-12 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1407225410 | Jeff Jones | Pharmacist | 5907 Old Mooringsport Rd, Shreveport, LA 71107-2023 | 2015-09-20 |
| 1063816353 | Rita Saye | Pharmacist | 319 Albany Ave, Shreveport, LA 71105-2001 | 2014-10-15 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71104 |
Please comment or provide details below to improve the information on DR. RICKY ADONIS JACKSON.
| 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.