Individual provider Active NPI

Jordan Elisha Wheeler

  • Pharmacist
  • Huber Heights, OH
National Provider Identifier
1013532217
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03134834 Issued in OH
Practice address
5000 Brandt Pike
Huber Heights, OH 45424-6108
Phone
(937) 236-0495
Fax
(937) 236-1398
NPI assigned
Jun 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03134834 OH Primary

Addresses

Primary practice location

5000 Brandt Pike
Huber Heights, OH 45424-6108

Mailing address

5000 Brandt Pike
Huber Heights, OH 45424-6108
Phone (937) 236-0495

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

State licenses

LicenseStateTypeSpecialty
03134834OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Mar 13, 2022 Accepting new patients
Walgreen Co PastSince Jun 14, 2020 Accepting new patients

Locations

5000 Brandt Pike
Huber Heights, OH 45424
Phone (937) 236-0495

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": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1013532217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BRANDT PIKE",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454246108",
            "telephone_number": "937-236-0495",
            "fax_number": "937-236-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BRANDT PIKE",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454246108",
            "telephone_number": "937-236-0495",
            "fax_number": "937-236-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "JORDAN",
        "middle_name": "ELISHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03134834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huber Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.