Jignesh Mandavia

Primary specialty

PharmacistTaxonomy code 183500000X

License

17809 Issued in MD

Practice address

10215 McIntyre Ridge Rd
101
Pineville, NC 28134

Phone

(704) 831-9212

Fax

(704) 831-9214

NPI assigned

Mar 3, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prime Specialty Pharmacy

  • Pharmacy
  • Pineville, NC
  • NPI 1316651482
  NPD Authorized official

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1235437005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 WEDDINGTON RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281056665",
            "telephone_number": "704-246-6376",
            "fax_number": "704-849-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 MCINTYRE RIDGE RD",
            "address_2": "101",
            "city": "PINEVILLE",
            "state": "NC",
            "postal_code": "28134",
            "telephone_number": "704-831-9212",
            "fax_number": "704-831-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAVIA",
        "first_name": "JIGNESH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-03",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "17809",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "18135",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhea Lourens, LCMHCA
• Luminous Eyes Optometry PLLC
• Luxottica of America Inc.
• Tonya Theresa Mack, LPTA
• Roy Alan Majors, MD
• Catherine V Martin
• Pamela Martin
• Anthony McNeill, NP
• Corinne P Meynardie, APRN
• Linda Zivic Miller, SLP

• Pharmacist in Pineville, NC
• Providers in Pineville, NC by specialty
• Pharmacist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.