Jordan David Rupp, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

7720480-1701 Issued in UT

Practice address

4045 E Pony Express Pkwy
Eagle Mountain, UT 84005-5512

Phone

(801) 789-4997

NPI assigned

Aug 17, 2022

Last updated

Aug 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Ridleys Family Markets Inc

  dba Ridley's Pharmacy #1165

  • Community/Retail Pharmacy
  • Eagle Mountain, UT
  • NPI 1548681877
  NPD (past)
• Ridley's Family Markets, Inc

  • Community/Retail Pharmacy
  • Spring Creek, NV
  • NPI 1386467009
  NPD (past)

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1114645082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 E PONY EXPRESS PKWY",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840055512",
            "telephone_number": "801-789-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 E PONY EXPRESS PKWY",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840055512",
            "telephone_number": "801-789-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPP",
        "first_name": "JORDAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-17",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "7720480-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ridleys Family Markets Inc (Ridley's Pharmacy #1165)
• Ridleys Family Markets Inc (City Center Pharmacy)
• Rise & Thrive Counseling LLC
• Jared Michael Roberts
• Tyson Roberts, PA
• Brenda Isui Sanchez Gomez
• Tamara Jean Sasser
• Kyler Saunders, DPT
• Cheryl Scholes, NP-C
• Katie Shelley

• Pharmacist in Eagle Mountain, UT
• Providers in Eagle Mountain, UT by specialty
• Pharmacist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.