Active NPI
James Larry Nordin
- Pharmacist
- Brookhaven, MS
National Provider Identifier
1063024628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-006337
- Practice address
- 719 Brookway Blvd
Brookhaven, MS 39601-2639 - Phone
- (601) 833-8509
- Fax
- (601) 833-9626
- NPI assigned
- Aug 17, 2020
- Last updated
- Aug 17, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E06337 | MS | |
| Pharmacist | 183500000X | E-006337 | MS | Primary |
Addresses
Primary practice location
719 Brookway Blvd
Brookhaven, MS 39601-2639
Mailing address
339 McCluer Rd
Jackson, MS 39212-5412
Phone (601) 955-6636
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
| License | State | Type | Specialty |
|---|---|---|---|
| E-006337 | MS | MD | Pharmacist |
| E06337 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597622400000",
"number": "1063024628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "339 MCCLUER RD",
"city": "JACKSON",
"state": "MS",
"postal_code": "392125412",
"telephone_number": "601-955-6636",
"fax_number": "601-833-9626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "719 BROOKWAY BLVD",
"city": "BROOKHAVEN",
"state": "MS",
"postal_code": "396012639",
"telephone_number": "601-833-8509",
"fax_number": "601-833-9626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORDIN",
"first_name": "JAMES",
"middle_name": "LARRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-17",
"last_updated": "2020-08-17",
"certification_date": "2020-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E06337",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-006337",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookhaven, MS
- Angelia Yvonne Nelson, LPN
- New Viality
- Ashton Kyle Newman, FNP-C
- Shamekia Nichols
- Krhistyn Dimetrias Noble
- Nurse Practitioner Professionals, PLLC (Theresa Renee King)
- Samantha Occhipinti, MS, CCC-SLP
- Ole Brook Kids, P.C. (Ole Brook Kids Wellness and Urgent Care)
- Ole Brook Optical, Inc
- Passionate Care Home Health,LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.