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Deactivated NPI 1184066631 Deactivated / Inactive NPI Male Practitioner

Irvin Travis Jackson

Pharmacist • Pine Bluff, AR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Irvin Jackson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 25, 2013
NPI Deactivation Date January 02, 2025
Total Practice Duration ~12 Years of Practice (2013 – 2025)

Professional Overview & Biography Verified Profile Summary

Irvin Jackson was a registered Pharmacist practicing in Pine Bluff, AR. Throughout an active medical career spanning 12 years, Irvin Jackson provided care at the practice location at 4720 DOLLARWAY RD until profile deactivation on 2025-01-02.

Practice Location & Contact Primary Location

Practice Address

4720 Dollarway Rd

Pine Bluff, AR 716024126

Telephone 8705347876
Fax 8705344677

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Pine Bluff, AR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.5 Yrs
Regional Practice Density
45 Specialists

Practicing in Pine Bluff, AR (2976 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License AR PD06427

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Donna Johnson

Pharmacist

NPI 1376985424
NPI 1780090084

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 02, 2025

Record deactivated on January 02, 2025

NPI Profile Active July 25, 2013

NPI status registered as active in NPPES database

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Updated Practice Location July 25, 2013

Registered at 4720 DOLLARWAY RD, PINE BLUFF, AR 716024126 (Tel: 8705347876)

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Updated Business Mailing Address July 25, 2013

Registered at 4720 DOLLARWAY RD, PINE BLUFF, AR 716024126 (Tel: 8705347876)

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Provider Name / Credentials Updated July 25, 2013

Recorded as IRVIN JACKSON

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 25, 2013

Pharmacist (License #PD06427 in AR)

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Initial NPI Registration & Enumeration July 25, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1184066631
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 25, 2013
Last Update: July 25, 2013
Deactivation Date: January 02, 2025

Mailing Address

4720 Dollarway Rd

Pine Bluff, AR 716024126

Phone: 8705347876

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.