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Deactivated NPI 1396011037 Deactivated / Inactive NPI Male Practitioner

Jay D Slack , RPH

Pharmacist • Springfield, MO

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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, Jay Slack has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 27, 2012
NPI Deactivation Date February 15, 2023
Total Practice Duration ~11 Years of Practice (2012 – 2023)

Professional Overview & Biography Verified Profile Summary

Jay Slack, RPH was a registered Pharmacist practicing in Springfield, MO. Throughout an active medical career spanning 11 years, Jay Slack provided care at the practice location at 1825 E PRIMROSE ST until profile deactivation on 2023-02-15.

Practice Location & Contact Primary Location

Practice Address

1825 E Primrose St

Springfield, MO 658046497

Telephone 4175201745
Associated Practice Facility / Clinic
🏢 Missouri Cvs Pharmacy Llc Facility NPI 1396786331

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Springfield, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 8.0 Yrs
State Avg: 10.7 Yrs
Regional Practice Density
244 Specialists

Practicing in Springfield, MO (5469 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 MO 2002006434

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

5 Associated Practitioners
NPI 1083218671

Doctor of Pharmacy (Pharm.D.)

NPI 1215378682

Doctor of Pharmacy (Pharm.D.)

NPI 1649567272

Doctor of Pharmacy (Pharm.D.)

NPI 1811209976

Registered Pharmacist

NPI 1982998746

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 February 15, 2023

Record deactivated on February 15, 2023

NPI Profile Active March 27, 2012

NPI status registered as active in NPPES database

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Updated Practice Location March 27, 2012

Registered at 1825 E PRIMROSE ST, SPRINGFIELD, MO 658046497 (Tel: 4175201745)

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Updated Business Mailing Address March 27, 2012

Registered at 1825 E PRIMROSE ST, SPRINGFIELD, MO 658046497 (Tel: 4175201745)

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Provider Name / Credentials Updated March 27, 2012

Recorded as JAY SLACK, R.PH

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 27, 2012

Pharmacist (License #2002006434 in MO)

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Initial NPI Registration & Enumeration March 27, 2012

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: 1396011037
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 27, 2012
Last Update: March 27, 2012
Deactivation Date: February 15, 2023

Mailing Address

1825 E Primrose St

Springfield, MO 658046497

Phone: 4175201745

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.