Individual provider Active NPI

Justin Kelly Roberts, PHARMD

  • Pharmacist
  • Aynor, SC
National Provider Identifier
1356210207
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
60844 Issued in SC
Practice address
240 8TH Ave
Aynor, SC 29511-3222
Phone
(843) 358-2000
Fax
(843) 358-2524
NPI assigned
Oct 30, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 60844 SC Primary

Addresses

Primary practice location

240 8TH Ave
Aynor, SC 29511-3222

Mailing address

240 8TH Ave
Aynor, SC 29511-3222
Phone (843) 358-2000

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

LicenseStateTypeSpecialty
60844SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Aynor Home Medical Equipment, Inc. CurrentSince Nov 8, 2025 Accepting new patients
Aynor Family Pharmacy, Inc PastSince Nov 8, 2025 Accepting new patients

Locations

240 8th Ave
Aynor, SC 29511
Phone (843) 358-2000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1761782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1356210207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 8TH AVE",
            "city": "AYNOR",
            "state": "SC",
            "postal_code": "295113222",
            "telephone_number": "843-358-2000",
            "fax_number": "843-358-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 8TH AVE",
            "city": "AYNOR",
            "state": "SC",
            "postal_code": "295113222",
            "telephone_number": "843-358-2000",
            "fax_number": "843-358-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JUSTIN",
        "middle_name": "KELLY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-30",
        "last_updated": "2025-11-07",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "60844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aynor, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; 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.