MR. JERRY LEE YOUNG (NPI# 1538244504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538244504 |
| Entity Type | Individual |
| Full Name | MR. JERRY LEE YOUNG |
| Practice Address |
154 Main St Decatur AR 72722 |
| Practice Telephone | 4797525888 |
| Practice Fax Number | 4797525624 |
| Mailing Telephone | 4797525888 |
| Mailing Fax Number | 4797525624 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | AR 16392 | AR | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609077957 | Jerry A Young | Dentist | 14 E Silver St, Lebanon, OH 45036-1804 | 2007-05-31 |
| 1669573424 | Jerry E Young | Dentist | 208 West 4th Street, Holton, KS 66436 | 2006-09-26 |
| 1154408235 | Jerry D Young | Surgery | 600 Hospital Cir, Suite 201, Bay City, TX 77414-4771 | 2006-11-01 |
| 1417045485 | Jerry P. Young | Dentist | 646 N Diamond Bar Blvd, Diamond Bar, CA 91765-1037 | 2006-10-11 |
| 1104857333 | Jerry Tuck Young | Optometrist | 623 E Matthews Ave, Jonesboro, AR 72401-3145 | 2006-07-05 |
| 1760458871 | Jerry V Young | Anesthesiology | 550 University Blvd, Indianapolis, IN 46202-5149 | 2006-02-28 |
| Street Address |
154 MAIN ST |
| City | DECATUR |
| State | AR |
| Zip Code | 72722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992842595 | Veronica G Dockery | Physician Assistant | 346 N. Main St, Decatur, AR 72722-0735 | 2007-01-31 |
| 1023028016 | Spavinaw Clinics, Inc | Clinic/Center | 346 N. Main Street, Decatur, AR 72722-0735 | 2006-08-09 |
| 1205848249 | John L Garrett | Family Medicine | 346 N Main St, Decatur, AR 72722-0735 | 2006-08-11 |
| 1194330951 | Melissa Logan | Registered Nurse | 8099 Warren Rd, Decatur, AR 72722-9406 | 2020-09-09 |
| 1952704892 | Wal-mart Stores Inc | Pharmacy | 154 E Roller Ave, Decatur, AR 72722-9446 | 2014-10-07 |
| 1053461004 | Decatur School District | Local Education Agency (LEA) | 1441 E Roller Ave, Decatur, AR 72722-9650 | 2007-01-11 |
| 1477511434 | Jeff Paul Honderich | Family Medicine | 346 N Main St, Decatur, AR 72722-9732 | 2006-05-01 |
| 1871013359 | Laticia Kay Sheffield | Family Medicine | 346 N Main St, Decatur, AR 72722-9732 | 2017-06-26 |
| 1316338361 | Jesse A Stafford | Physician Assistant | 346 N Main St, Decatur, AR 72722-9732 | 2015-02-12 |
| 1629493549 | Mitchell Atkins | Nurse Practitioner | 346 N Main St, Decatur, AR 72722-9732 | 2014-02-28 |
| Find all providers in zip 72722 | ||||
| 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 |
|---|---|---|---|---|
| 1811515927 | Kristin Lynne Mcdonald | Pharmacist | 82 Deerfield Ln, Decatur, MS 39327-8977 | 2020-07-06 |
| 1629699699 | Samantha Camille Ricks | Pharmacist | 2641 E College Ave Apt 736, Decatur, GA 30030-3380 | 2020-04-30 |
| 1447886056 | Sawapha Verduci | Pharmacist | 1375 Thomas Rd, Decatur, GA 30030-4622 | 2020-03-14 |
| 1386280949 | Kelsie Burner | Pharmacist | 1818 Airport Plz, Decatur, IL 62521-9717 | 2019-11-19 |
| 1699319541 | Thao Trinh Nguyen | Pharmacist | 1130 N Jamestown Rd Apt 305, Decatur, GA 30033-7118 | 2019-11-04 |
| 1770067506 | Abdul Wahab | Pharmacist | 3517 Clubhouse Cir E Apt A, Decatur, GA 30032-2006 | 2018-09-18 |
| 1225514797 | Erkin Mirkhatovich Turganov | Pharmacist | 2951 Cedar Brook Dr, Decatur, GA 30033 | 2018-07-17 |
| 1639604408 | Mahesh Patel | Pharmacist | 2579 Lawrenceville Hwy, Decatur, GA 30033-3206 | 2017-04-28 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1831568278 | Omeka Clark | Pharmacist | 1670 Clairmont Road (119), Decatur, GA 30033 | 2015-09-16 |
| Find all providers in DECATUR | ||||
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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.