DR. TROY M JACKMAN (NPI# 1609414051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609414051 |
Entity Type | Individual |
Full Name | DR. TROY M JACKMAN |
Credential | PHARMD |
Practice Address |
709 N Lincoln Ave Jerome ID 83338-1851 |
Practice Telephone | 2088149716 |
Practice Fax Number | 2088149587 |
Mailing Telephone | 2088149716 |
Mailing Fax Number | 2088149587 |
Enumeration Date | 2019-12-17 |
Last Update Date | 2019-12-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
P5259 | ID | Pharmacy Service Providers |
Street Address |
709 N LINCOLN AVE |
City | JEROME |
State | ID |
Zip Code | 83338-1851 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336138783 | Brian Lee Johnson | Family Medicine | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2005-10-18 |
1891165569 | Anne B Fullmer | Nurse Practitioner | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2015-10-06 |
1366874877 | St Luke's Magic Valley Regional Medical Center Ltd | General Acute Care Hospital | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2013-08-07 |
1730511254 | St Lukes Magic Valley Regional Medical Center Ltd | Medicare Defined Swing Bed Unit | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2013-08-07 |
1912137175 | Paul A Dickinson | Nurse Anesthetist, Certified Registered | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2009-07-22 |
1700053774 | St Benedicts Fmc Physician Assistants | Physician Assistant | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2008-05-09 |
1083833933 | Thomas Henry Zepeda | Personal Emergency Response Attendant | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2007-04-25 |
1639211634 | St. Benedicts Family Medical Center | Long Term Care Hospital | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2007-02-13 |
1750489647 | Richard Emery Lally | Emergency Medicine | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2006-09-21 |
1902856727 | St Benedicts Family Medical Center | Skilled Nursing Facility | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2006-05-11 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295336709 | Family Health Services Pharmacy | Pharmacy | 218 W. Nez Perce, Jerome, ID 83338 | 2020-11-03 |
1811391626 | Summit Therapy Services | In Home Supportive Care | 113 East Ave. F, Jerome, ID 83338 | 2014-10-22 |
1952645285 | Readings Community Pharmacy Inc | Pharmacy | 133 West A, Jerome, ID 83338 | 2012-11-27 |
1801121298 | Yolanda S. Sedano | Physician Assistant | 132 5th Ave West, Jerome, ID 83338 | 2009-10-02 |
1295898310 | Ronald Gail Hendrickson | Dentist | 128 South Adams, Jerome, ID 83338 | 2006-12-19 |
1316035512 | Johnson Chiropractic Clinic | Chiropractor | 600 N Lincoln Ave, Jerome, ID 83338 | 2006-10-11 |
1265527725 | Lon M. Egbert, P.C. | Specialist/Technologist | 128 5th Ave West, Jerome, ID 83338 | 2006-10-03 |
1992898605 | St Benedicts Family Medical Center | Home Health | 414 N Lincoln, Suite 1, Jerome, ID 83338 | 2006-10-02 |
1790231355 | Lexa Marie Balling | Pharmacist | 2680 S Lincoln Ave, Jerome, ID 83338 | 2016-09-01 |
1922037530 | St Benedicts Family Medical Center | Clinic/Center | 115 5th Ave W, Jerome, ID 83338-1824 | 2006-07-03 |
Find all providers in zip 83338 |
Taxonomy Code | 1835P0018X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
1417595067 | Teresa Janeen Newsom | Pharmacist | 2840 S Swallowtail Ln, Boise, ID 83706-6138 | 2019-12-13 |
1255714879 | Kristin Helmboldt | Pharmacist | 2309 E Cyanite Dr, Meridian, ID 83642-9072 | 2015-07-01 |
1932480431 | Amy Anne Mcdougal | Pharmacist | 1066 N Yellowstone Hwy, Rexburg, ID 83440-5103 | 2011-08-30 |
1932496650 | Charlotte Loring | Pharmacist | 909 E Park Center B;vd, Boise, ID 83706 | 2011-07-01 |
1215237144 | Jacqueline K Kavila | Pharmacist | 2809 E. Cleveland Blvd, Caldwell, ID 83605 | 2010-10-26 |
1508096777 | Kim E. Tillery | Pharmacist | 2638 Longbow Dr, Twin Falls, ID 83301-8946 | 2009-07-21 |
1093314866 | Gregory Aaron Carter | Pharmacist | 2327 Coronado St, Idaho Falls, ID 83404-7407 | 2020-10-22 |
1316544604 | James K Hunter | Pharmacist | 301 Aspen Sq, Saint Anthony, ID 83445-1662 | 2020-10-08 |
1629689799 | Tanna Marie Schlader | Pharmacist | 50 2nd St S, Nampa, ID 83651-3700 | 2020-08-12 |
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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.