Active NPI
Jordan Anderson
- Pharmacist
- Waipahu, HI
National Provider Identifier
1235975541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S025967
- Practice address
- 94-1480 Moaniani St
Waipahu, HI 96797-4632 - Phone
- (833) 833-3333
- NPI assigned
- Jul 5, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH-5027 | HI | |
| Pharmacist | 183500000X | S025967 | AZ | Primary |
Addresses
Primary practice location
94-1480 Moaniani St
Waipahu, HI 96797-4632
Mailing address
91-229 Loululelo PL
Kapolei, HI 96707-3108
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 |
|---|---|---|---|
| S025967 | AZ | MD | Pharmacist |
| PH-5027 | HI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720137600000",
"number": "1235975541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91-229 LOULULELO PL",
"city": "KAPOLEI",
"state": "HI",
"postal_code": "967073108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-1480 MOANIANI ST",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967974632",
"telephone_number": "833-833-3333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JORDAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-05",
"last_updated": "2024-07-05",
"certification_date": "2024-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "PH-5027",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S025967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waipahu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.