Active NPI
Mary Jackson
- Pharmacist
- Spartanburg, SC
National Provider Identifier
1447704333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36729
- Practice address
- 141 Dorman Centre Dr
Spartanburg, SC 29301-2625 - Phone
- (864) 574-1985
- NPI assigned
- Aug 8, 2016
- Sex
- Female
- Sole proprietor
- No
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 | 36729 | SC | Primary |
Addresses
Primary practice location
141 Dorman Centre Dr
Spartanburg, SC 29301-2625
Mailing address
141 Dorman Centre Dr
Spartanburg, SC 29301-2625
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 |
|---|---|---|---|
| 36729 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470614400000",
"number": "1447704333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 DORMAN CENTRE DR",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293012625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 DORMAN CENTRE DR",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293012625",
"telephone_number": "864-574-1985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-08",
"last_updated": "2016-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "36729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.