DR. JACKSON ALLEN KICKLIGHTER (NPI# 1255948345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255948345 |
Entity Type | Individual |
Full Name | DR. JACKSON ALLEN KICKLIGHTER |
Credential | PHARMD |
Practice Address |
4310 W Wendover Ave Greensboro NC 27407-1911 |
Mailing Address |
3911 Woodberry Lake Dr Greensboro NC 27455-0945 |
Practice Telephone | 3362940335 |
Mailing Telephone | 7068715549 |
Enumeration Date | 2020-09-23 |
Last Update Date | 2020-09-23 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 183500000X | Pharmacist | 29807 | NC | Pharmacy Service Providers |
Street Address |
4310 W WENDOVER AVE |
City | GREENSBORO |
State | NC |
Zip Code | 27407-1911 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619070471 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4310 W Wendover Ave, Greensboro, NC 27407-1911 | 2006-09-07 |
1457830259 | Ankit Paresh Patel | Pharmacist | 4310 W Wendover Ave, Greensboro, NC 27407-1911 | 2018-08-13 |
1508380593 | Malia Yang | Pharmacist | 4310 W Wendover Ave, Greensboro, NC 27407-1911 | 2017-08-01 |
1134642283 | Jacalyn R Schroeder | Pharmacist | 4310 W Wendover Ave, Greensboro, NC 27407-1911 | 2017-07-20 |
1316471246 | Cvs Pharmacy | Pharmacist | 4310 W Wendover Ave, Greensboro, NC 27407-1911 | 2017-04-18 |
1629502695 | Shamirkumar Patel | Pharmacist | 4310 W Wendover Ave, Greensboro, NC 27407-1911 | 2017-04-17 |
1770017774 | Cvs Pharmacy Inc. | Pharmacy | 4310 W Wendover Ave, Greensboro, NC 27407-1911 | 2017-04-17 |
1437609724 | Cvs Pharmacy | Pharmacist | 4310 W Wendover Ave, Greensboro, NC 27407-1911 | 2016-10-11 |
1851688964 | Susan Murphy | Pharmacist | 4310 W Wendover Ave, Greensboro, NC 27407-1911 | 2011-07-09 |
1124315239 | Matthew Stephen Hogan | Pharmacist | 4310 W Wendover Ave, Greensboro, NC 27407-1911 | 2011-07-09 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093326019 | Marie Louise Phillips | Behavior Technician | 111 Domona Dr, Unit 6, Greensboro, NC 27407 | 2020-08-13 |
1306472709 | Blondine Yvonne Wynn | Home Health Aide | 2812 Apt 2g Vanstory Street, Greesboro, NC 27407 | 2020-03-17 |
1104452994 | Monyetta Marie Howell | Counselor | 2216 W. Meadowview Road, Wilmington Bldg. Suite 207, Greensboro, NC 27407 | 2020-03-12 |
1215456769 | Tiffany R. Wright | Massage Therapist | 317 H South Westgate Drive, Greensboro, NC 27407 | 2017-09-15 |
1992225676 | Kendra Edwards | Social Worker | 1 Centerview Dr Ste 103, Greensboro, NC 27407 | 2017-06-22 |
1477902674 | Triad Integrative Wellness Center Inc | Acupuncturist | 315j South Westgate Dr, Greensboro, NC 27407 | 2016-06-08 |
1083098354 | Kathryn Theall | Counselor | 1901 Adams Farm Pkwy, Greensboro, NC 27407 | 2015-07-16 |
1962886333 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 5710-w West Gate City Blvd, Greensboro, NC 27407 | 2015-07-16 |
1619356177 | Lindsey King | Registered Nurse | 302 Pomona Drive, Greensboro, NC 27407 | 2015-05-29 |
1255737664 | M.a.p.p.s. | Clinic/Center | 2216 West Meadowview Road Ste 204, Greensboro, NC 27407 | 2014-11-12 |
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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 |
---|---|---|---|---|
1487263224 | Kevin Alen Castro | Pharmacist | 5245 Fox Hunt Dr Apt D, Greensboro, NC 27407-7130 | 2020-07-28 |
1710444161 | Stephen Furr | Pharmacist | 1131 N Church St Ste D, Greensboro, NC 27401-1016 | 2019-02-21 |
1093292237 | Andrew Robertson | Pharmacist | 1903 W. Florida St, Greensboro, NC 27403 | 2018-07-20 |
1821575176 | Donald Matson Keiser IIi | Pharmacist | 6380 Lake Oconee Parkway, Greensboro, GA 30642 | 2018-07-19 |
1457846495 | Courtney Canty James | Pharmacist | 3300 W Friendly Ave, Greensboro, NC 27410 | 2018-06-22 |
1316482573 | William Joseph Watson Jr. | Pharmacist | 3313 Horse Pen Creek Rd Unit 3g, Greensboro, NC 27410-9816 | 2016-12-27 |
1962959288 | Huong Ni | Pharmacist | 3230 Randleman Rd, Suite C, Greensboro, NC 27406-6565 | 2016-09-02 |
1710433685 | Hue Kim Nguyen | Pharmacist | 12039 Greensboro Rd, Greensboro, MD 21639-1106 | 2016-08-30 |
1497145346 | Nathan Kennedy | Pharmacist | 1250 Revolution Mill Dr, Suite 3, Greensboro, NC 27405 | 2015-01-30 |
1174932750 | Matthew Jones | Pharmacist | 401 Pisgah Church Rd, Greensboro, NC 27455-2521 | 2014-08-07 |
Find all providers in GREENSBORO |
City | GREENSBORO |
Zip Code | 27407 |
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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.