DR. JACOB IVEY (NPI# 1235779125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235779125 |
| Entity Type | Individual |
| Full Name | DR. JACOB IVEY |
| Credential | PHARM D |
| Practice Address |
3333 W Deyoung St Marion IL 62959-5884 |
| Mailing Address |
11795 Songbird Rd Marion IL 62959-6877 |
| Practice Telephone | 6189987821 |
| Mailing Telephone | 6186941075 |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-01-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 2013011981 | MO | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | PHARMACIST | 2013011981 | 01 |
| IL | PHARMACIST | 051.291535 | 01 |
| FL | PHARMACIST | PS60361 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801283049 | Jacob A Ivey | Specialist | 7521 Jaguar Trl, Falls Church, VA 22042-7511 | 2015-04-24 |
| 1508885369 | Jacob A Ivey | Optometrist | 500 N Church Ave, Louisville, MS 39339-2016 | 2006-07-19 |
| Street Address |
3333 W DEYOUNG ST |
| City | MARION |
| State | IL |
| Zip Code | 62959-5884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922007533 | New Century Physicians of Southern Illinois Inc | Emergency Medicine | 3333 W Deyoung St, Marion, IL 62959-5884 | 2005-07-15 |
| 1538774898 | Russell Craig Arendt | Nurse Anesthetist, Certified Registered | 3333 W Deyoung St, Marion, IL 62959-5884 | 2020-09-14 |
| 1811515984 | Medcore Diagnostics LLC | Pathology | 3333 W Deyoung St, Marion, IL 62959-5884 | 2020-07-06 |
| 1942826540 | Joseph Michael Logan Oldani | Nurse Anesthetist, Certified Registered | 3333 W Deyoung St, Marion, IL 62959-5884 | 2020-06-19 |
| 1326662891 | Medcore Associates, Pllc | Pathology | 3333 W Deyoung St, Marion, IL 62959-5884 | 2020-06-01 |
| 1528627833 | Gregory Scott Clark | Nurse Anesthetist, Certified Registered | 3333 W Deyoung St, Marion, IL 62959-5884 | 2019-06-10 |
| 1194297879 | Jessica Hays | Nurse Practitioner | 3333 W Deyoung St, Marion, IL 62959-5884 | 2018-12-19 |
| 1598240145 | Amy Jo Blandford | Nurse Practitioner | 3333 W Deyoung St, Marion, IL 62959-5884 | 2018-09-29 |
| 1306322136 | Joshua Richardson | Registered Nurse | 3333 W Deyoung St, Marion, IL 62959-5884 | 2018-07-15 |
| 1518478122 | Gopath Pathology Group, LLC | Pathology | 3333 W Deyoung St, Marion, IL 62959-5884 | 2017-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513486 | Sarah Benitone | Counselor | 11264 Il-37, Marion, IL 62959 | 2020-03-13 |
| 1528609328 | Patricia E Murphy | Radiology | 4503 1/2 W Deyoung, Suite 3a, Marion, IL 62959 | 2019-10-02 |
| 1366007007 | Centerstone of Illinois, Inc | Community/Behavioral Health | 202 S Bentley St, Marion, IL 62959 | 2019-05-08 |
| 1649752064 | Sydney Seiter | Occupational Therapist | 906 Skyline Suite 100, Marion, IL 62959 | 2018-09-01 |
| 1497279848 | Brooke Alisa Osman | Licensed Practical Nurse | 11531 Sunderland Road, Marion, IL 62959 | 2017-07-27 |
| 1912436429 | Joy L. Kee | Social Worker | 509 South Bentley Street, Marion, IL 62959 | 2017-06-08 |
| 1386181170 | Susan Smothers | Counselor | 1305 West Main Street, Marion, IL 62959 | 2017-01-31 |
| 1205280922 | Harish Kempegowda | Orthopaedic Surgery | 3331 W Deyoung St Ste 201, Marion, IL 62959 | 2016-04-19 |
| 1942609227 | Casey Hill | Social Worker | 1604 W. Walnut St., Marion, IL 62959 | 2014-08-22 |
| 1306252812 | Justin M White | Chiropractor | 1603 W Kimmel, Marion, IL 62959 | 2014-07-03 |
| Find all providers in zip 62959 | ||||
| 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 |
|---|---|---|---|---|
| 1730780214 | Rhonda Leigh Herrmann | Pharmacist | 13969 Moore Rd, Marion, IL 62959-6835 | 2020-11-03 |
| 1083234314 | Michael Arthur Conrey | Pharmacist | 2790 7th Ave, Marion, IA 52302-3751 | 2020-04-16 |
| 1689170854 | Crystal Lacole Foxworth | Pharmacist | 1328 N Main St, Marion, SC 29571-2011 | 2018-04-04 |
| 1013410869 | Aaron Schmid | Pharmacist | 1821 W Riga Ave, Marion, IN 46952-1549 | 2018-03-16 |
| 1487153953 | Raquel Macfarlane | Pharmacist | 52 County Rd, Marion, MA 02738 | 2018-02-09 |
| 1154840924 | Tashena Elizabeth Hill | Pharmacist | 520 West Gum St., Marion, KY 42064 | 2017-09-13 |
| 1558750745 | Julie Pollard | Pharmacist | 2875 Sugarhill Road, Marion, NC 28752-5497 | 2015-01-12 |
| 1518214568 | Brian Lee Killian | Pharmacist | 1916 W 10th St, Marion, IN 46953-1239 | 2012-08-09 |
| 1811244734 | Adriane Ellen Miller | Pharmacist | 3037 Brookfield Dr, Marion, IA 52302-4781 | 2012-08-09 |
| 1265719546 | Tamalisa L Al-sultan | Pharmacist | 1321 Delaware Ave, Marion, OH 43302-6421 | 2011-11-15 |
| Find all providers in MARION | ||||
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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.