Active NPI
Jordan Christine Anderson, PHARMD
- Pharmacist
- Bangor, ME
National Provider Identifier
1336709377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PR69341
- Practice address
- 183 Center St
Bangor, ME 04401-4839 - Phone
- (207) 299-4094
- NPI assigned
- Jun 20, 2019
- Last updated
- Aug 6, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PR69341 | ME | Primary |
Addresses
Primary practice location
183 Center St
Bangor, ME 04401-4839
Mailing address
183 Center St
Bangor, ME 04401-4839
Phone (207) 299-4094
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 |
|---|---|---|---|
| PR69341 | ME | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1336709377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "183 CENTER ST",
"city": "BANGOR",
"state": "ME",
"postal_code": "044014839",
"telephone_number": "207-299-4094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "183 CENTER ST",
"city": "BANGOR",
"state": "ME",
"postal_code": "044014839",
"telephone_number": "207-299-4094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JORDAN",
"middle_name": "CHRISTINE",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-20",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ME",
"license": "PR69341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.