Active NPI
James Victor Mathis Jr., PHARM.D.
- Pharmacist
- Manning, SC
National Provider Identifier
1245641703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11113
- Practice address
- 12 N Brooks St
Manning, SC 29102-3206 - Phone
- (803) 435-2511
- Fax
- (803) 435-4235
- NPI assigned
- May 17, 2014
- Last updated
- May 17, 2014
- 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 | 11113 | SC | Primary |
Addresses
Primary practice location
12 N Brooks St
Manning, SC 29102-3206
Mailing address
12 N Brooks St
Manning, SC 29102-3206
Phone (803) 435-2511
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11113 | SC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santee Drug Center, LLC | Current | Accepting new patients | |
| Brunson's Pharmacy, LLC | Current | Accepting new patients | |
| Brunson's Pharmacy, LLC | Pharmacist | Current | Accepting new patients |
Locations
12 N Brooks St
Manning, SC 29102
Phone (803) 435-2511
Organizations & group practices 3
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.
-
- Pharmacist
- Manning, SC
- NPI 1710228440
-
dba Santee Drug Center
- Community/Retail Pharmacy
- Saint Stephen, SC
- NPI 1306882428
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400284800000",
"number": "1245641703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 N BROOKS ST",
"city": "MANNING",
"state": "SC",
"postal_code": "291023206",
"telephone_number": "803-435-2511",
"fax_number": "803-435-4235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 N BROOKS ST",
"city": "MANNING",
"state": "SC",
"postal_code": "291023206",
"telephone_number": "803-435-2511",
"fax_number": "803-435-4235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "JAMES",
"middle_name": "VICTOR",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-17",
"last_updated": "2014-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "11113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manning, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.