Active NPI
Jason William Bondarenka, RPH
- Pharmacist
- Johns Island, SC
National Provider Identifier
1134478456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11562
- Practice address
- 3062 Penny LN
Johns Island, SC 29455-8760 - Phone
- (843) 670-5556
- NPI assigned
- Aug 31, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11562 | SC | Primary |
Addresses
Primary practice location
3062 Penny LN
Johns Island, SC 29455-8760
Mailing address
3062 Penny LN
Johns Island, SC 29455-8760
Phone (843) 670-5556
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11562 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346371200000",
"number": "1134478456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3062 PENNY LN",
"city": "JOHNS ISLAND",
"state": "SC",
"postal_code": "294558760",
"telephone_number": "843-670-5556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3062 PENNY LN",
"city": "JOHNS ISLAND",
"state": "SC",
"postal_code": "294558760",
"telephone_number": "843-670-5556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONDARENKA",
"first_name": "JASON",
"middle_name": "WILLIAM",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-31",
"last_updated": "2012-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "11562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johns Island, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.