Individual provider Active NPI

Jonathan Made, PHARMD

  • Pharmacist
  • Cayce, SC
National Provider Identifier
1073385787
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
44152 Issued in SC
Practice address
2410 Charleston Hwy
Cayce, SC 29033-1736
Phone
(321) 945-0541
NPI assigned
Oct 25, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 44152 SC Primary

Addresses

Primary practice location

2410 Charleston Hwy
Cayce, SC 29033-1736

Mailing address

2410 Charleston Hwy
Cayce, SC 29033-1736
Phone (803) 796-2586

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
44152SCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1073385787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 CHARLESTON HWY",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290331736",
            "telephone_number": "803-796-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 CHARLESTON HWY",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290331736",
            "telephone_number": "321-945-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADE",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "44152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayce, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.