Jordan Carrillo

Primary specialty

PharmacistTaxonomy code 183500000X

License

275200 Issued in NC

Practice address

640 Jake Alexander Blvd W
Salisbury, NC 28147-1367

Phone

(704) 636-8852

NPI assigned

Mar 14, 2018

Last updated

Mar 14, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1457854622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8524 MASON ANDREW WAY APT 2116",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282160267",
            "telephone_number": "980-254-2323",
            "fax_number": "980-254-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JAKE ALEXANDER BLVD W",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281471367",
            "telephone_number": "704-636-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "275200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolinas Physicians Network Inc (Atrium Health Urgent Care)
• Carolinas Physicians Network Inc (The Sanger Clinic)
• Carolinas Physicians Network, Inc. (The Sanger Clinic)
• Kelly Bergeron Carpenter, NP-C
• Sierra Dawn Carpenter, AUD
• Danielle Carrington
• Jennifer Kelly Williams Carroll, PA-C
• Dakhari U Carter
• Eulishia Carter
• Jeffrey Carter, ED.S

• Pharmacist in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Pharmacist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; 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.