Active NPI
Jordan Gregory Sheppard
- Pharmacist
- Huntington, WV
National Provider Identifier
1174174304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP0011746
- Practice address
- 1249 15TH St
Huntington, WV 25701-3662 - Phone
- (304) 691-1420
- NPI assigned
- Sep 29, 2019
- Sex
- Male
- Sole proprietor
- No
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 | RP0011746 | WV | Primary |
Addresses
Primary practice location
1249 15TH St
Huntington, WV 25701-3662
Mailing address
1249 15TH St
Huntington, WV 25701-3662
Phone (304) 691-1420
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 |
|---|---|---|---|
| RP0011746 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588550400000",
"number": "1174174304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1249 15TH ST",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257013662",
"telephone_number": "304-691-1420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1249 15TH ST",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257013662",
"telephone_number": "304-691-1420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPPARD",
"first_name": "JORDAN",
"middle_name": "GREGORY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-29",
"last_updated": "2020-05-04",
"certification_date": "2020-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0011746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.