Individual provider Active NPI

Zachary Jordan, PHARM.D.

  • Pharmacist
  • Ladson, SC
National Provider Identifier
1013384239
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
36155 Issued in SC
Practice address
3685 Ladson Rd.
Ladson, SC 29456
Phone
(843) 879-5288
Fax
(843) 879-5287
NPI assigned
Aug 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 36155 SC Primary

Addresses

Primary practice location

3685 Ladson Rd.
Ladson, SC 29456

Mailing address

3685 Ladson Road
Ladson, SC 29456
Phone (843) 879-5288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
36155SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East, LP Past Accepting new patients
Wal-Mart Stores East LP Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1013384239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3685 LADSON ROAD",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "29456",
            "telephone_number": "843-879-5288",
            "fax_number": "843-879-5287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3685 LADSON RD.",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "29456",
            "telephone_number": "843-879-5288",
            "fax_number": "843-879-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ZACHARY",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "36155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.