MR. RYAN MICHAEL JACKSON (NPI# 1811125131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811125131 |
| Entity Type | Individual |
| Full Name | MR. RYAN MICHAEL JACKSON |
| Credential | PHARM.D |
| Practice Address |
2501 Cornhusker Dr South Sioux City NE 68776-3910 |
| Mailing Address |
2501 Cornhusker Plaza South Sioux City NE 68776 |
| Practice Telephone | 4024943021 |
| Practice Fax Number | 4024944969 |
| Mailing Telephone | 4024943021 |
| Mailing Fax Number | 4024944969 |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2009-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 11732 | NE | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194281287 | Ryan Theron Jackson | Behavior Technician | 1112 Parkway Cir N, Atlanta, GA 30340-6312 | 2019-02-14 |
| 1780665539 | Ryan Daniel Jackson | Chiropractor | 324 13th St, Franklin, PA 16323-1367 | 2005-11-09 |
| 1912566035 | Ryan R Jackson | Hearing Instrument Specialist | 92 Broadway, Denville, NJ 07834-2761 | 2019-06-12 |
| 1407318223 | Ryan C Jackson | Student in an Organized Health Care Education/Training Program | 22 S Greene St Rm N3e09, Baltimore, MD 21201-1595 | 2019-04-01 |
| 1164989257 | Ryan Jackson | Occupational Therapy Assistant | 535 S Elm St, Itasca, IL 60143-2187 | 2019-02-25 |
| 1194292060 | Ryan Jackson | Pharmacist | 960 Ross St, Heflin, AL 36264-1164 | 2018-10-30 |
| 1699153130 | Ryan Patrick Jackson | Student in an Organized Health Care Education/Training Program | 300 Pasteur Dr, Rm Hc435, Mc 5207, Stanford, CA 94305-2200 | 2015-05-18 |
| 1609216316 | Ryan L Jackson | Speech-Language Pathologist | 151 Southwest Dr, Jonesboro, AR 72401-5828 | 2013-06-26 |
| 1184060188 | Ryan Christopher Jackson | Emergency Medicine | 22 Bramhall St, Portland, ME 04102-3134 | 2013-05-16 |
| 1710114582 | Ryan Scott Jackson | Otolaryngology | 4921 Parkview Pl, Ste 11a, Saint Louis, MO 63110-1032 | 2009-06-18 |
| Street Address |
2501 CORNHUSKER DR |
| City | SOUTH SIOUX CITY |
| State | NE |
| Zip Code | 68776-3910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083650964 | Hy Vee Inc | Durable Medical Equipment & Medical Supplies | 2501 Cornhusker Dr, South Sioux City, NE 68776-3910 | 2006-06-21 |
| 1528519683 | Alisha Thompson | Dietitian, Registered | 2501 Cornhusker Dr, South Sioux City, NE 68776-3910 | 2016-10-24 |
| 1225459621 | Corrinna Lenort | Dietitian, Registered | 2501 Cornhusker Dr, South Sioux City, NE 68776-3910 | 2014-01-02 |
| 1184971319 | Rebecca Strong | Pharmacist | 2501 Cornhusker Dr, South Sioux City, NE 68776-3910 | 2012-08-07 |
| 1184956724 | Hy-vee | Community/Behavioral Health | 2501 Cornhusker Dr, South Sioux City, NE 68776-3910 | 2010-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437704251 | Integrated Diagnostics | Pathology | 201 East 4th Street, Suite 203, South Sioux City, NE 68776 | 2019-08-08 |
| 1003374711 | Riverview Surgical Center LLC | Clinic/Center | 201 E 4th Street, South Sioux City, NE 68776 | 2019-03-12 |
| 1144777665 | Emily Malchow | Speech-Language Pathologist | 820 E. 29th St., South Sioux City, NE 68776 | 2016-09-01 |
| 1477856011 | Hospice of Siouxland | Hospice Care, Community Based | 3220 Plaza Dr Ste D, South Sioux City, NE 68776 | 2010-12-20 |
| 1114101839 | Stacy Erin Rose | Counselor | 100 West 29th St, Suite 319, South Sioux, NE 68776 | 2007-12-18 |
| 1194867663 | Fern Norris | Counselor | 625 East 39th Street, South Sioux City, NE 68776 | 2007-02-13 |
| 1689750937 | Elizabeth Joan Munch | Dentist | 3220 Plaza Dr., Suite B, South Sioux City, NE 68776 | 2006-10-30 |
| 1841376191 | Douglas M. Barr | Dentist | 3220 Plaza Drive Ste B, So Sioux City, NE 68776 | 2006-10-30 |
| 1336245521 | Wal-mart Stores, Inc. | Technician/Technologist | 1601 Cornhuskers Drive, South Sioux City, NE 68776 | 2006-09-15 |
| 1316049752 | Redlers Prof Phcy Inc | Durable Medical Equipment & Medical Supplies | 1010 W 29th St, Ste 214, South Sioux City, NE 68776 | 2006-09-05 |
| Find all providers in zip 68776 | ||||
| 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 |
|---|---|---|---|---|
| 1023361011 | Sonya Lynette Sedahl | Pharmacist | 2501 Cornhusker Plaza, Hy-vee Pharmacy #1620, South Sioux City, NE 68776-3910 | 2012-10-16 |
| 1598383028 | Kayla Guy | Pharmacist | 1030 W 21st St, South Sioux City, NE 68776-2661 | 2020-07-10 |
| 1356816524 | Syra Ruhl | Pharmacist | 1030 W 21st St, South Sioux City, NE 68776-2661 | 2018-10-03 |
| 1902303977 | Mathew William Macziewski | Pharmacist | 1601 Cornhusker Dr, South Sioux City, NE 68776-3924 | 2018-04-06 |
| 1093222150 | Jamie Thoene | Pharmacist | 1601 Cornhusker Dr, South Sioux City, NE 68776-3924 | 2018-01-10 |
| 1215443478 | Kristin Rumsey | Pharmacist | 1601 Cornhusker Dr, South Sioux City, NE 68776-3924 | 2017-12-22 |
| 1316452485 | Tammy J Cox | Pharmacist | 1601 Cornhusker Dr, South Sioux City, NE 68776-3924 | 2017-12-11 |
| 1215448436 | Jeremy Wells | Pharmacist | 1030 W 21st St, South Sioux City, NE 68776-2661 | 2017-10-15 |
| 1184971319 | Rebecca Strong | Pharmacist | 2501 Cornhusker Dr, South Sioux City, NE 68776-3910 | 2012-08-07 |
| 1467729103 | Tally Shannon Stark | Pharmacist | 1030 W 21st St, South Sioux City, NE 68776-2661 | 2011-11-23 |
| Find all providers in SOUTH SIOUX CITY | ||||
| City | SOUTH SIOUX CITY |
| Zip Code | 68776 |
Please comment or provide details below to improve the information on MR. RYAN MICHAEL 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.