Active NPI
Jack Pershing Padgett Jr., BS, RPH
- Pharmacist
- Bamberg, SC
National Provider Identifier
1194711689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4186
- Practice address
- 540 North St
Bamberg, SC 29003-1319 - Phone
- (803) 245-4298
- Fax
- (803) 245-1232
- NPI assigned
- Sep 21, 2005
- Last updated
- Jul 13, 2026
- 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 | 4186 | SC | Primary |
Addresses
Primary practice location
540 North St
Bamberg, SC 29003-1319
Mailing address
540 North St
Bamberg, SC 29003-1319
Phone (803) 245-4298
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE1340 | Other | SC | DME MEDICAID |
| 4202329 | Other | NABP | |
| 716647 | Medicaid | SC |
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
- Bachelor of Science, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4186 | SC | MD | Public Health & General Preventive Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jack P. Padgett Jr. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Padgett's Drive in Pharmacy
- Community/Retail Pharmacy
- Bamberg, SC
- NPI 1851474100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1194711689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 NORTH ST",
"city": "BAMBERG",
"state": "SC",
"postal_code": "290031319",
"telephone_number": "803-245-4298",
"fax_number": "803-245-1232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 NORTH ST",
"city": "BAMBERG",
"state": "SC",
"postal_code": "290031319",
"telephone_number": "803-245-4298",
"fax_number": "803-245-1232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PADGETT",
"first_name": "JACK",
"middle_name": "PERSHING",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "BS, RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "4186",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DME MEDICAID",
"identifier": "DE1340",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "4202329",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "716647",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bamberg, SC
- Musc Community Physicians (MUSC Health Primary Care - Bamberg)
- Musc Community Physicians (MUSC Community Physicians Specialty)
- Musc Community Physicians (MUSC Community Physicians PC)
- Cynthia C Nipper, RPH
- Nra-Bamberg, South Carolina, LLC (Bamberg Dialysis Clinic)
- Palmetto Health (Palmetto Health Hospice)
- Mary Catharine Philbeck, MD
- Providence Cardiology LLC (Providence Cardiology)
- Pruitthealth - Bamberg, LLC (PruittHealth - Bamberg)
- Gloria Reed, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.