Active NPI
Jordan L Bundy, PHARMD
- Pharmacist
- Portland, ME
National Provider Identifier
1518449172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PR46968
- Practice address
- 22 Bramhall St
Portland, ME 04102-3134 - Phone
- (207) 662-2801
- NPI assigned
- Aug 30, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHCY-04371 | NH | |
| Pharmacist | 183500000X | PR46968 | ME | Primary |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102-3134
Mailing address
PO Box 1471
Portland, ME 04104-1471
Other practice location 1
50 Boulder Way
Biddeford, ME 04005-9442
Phone (207) 286-9562
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 |
|---|---|---|---|
| PR46968 | ME | MD | Pharmacist |
| PHCY-04371 | NH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535587200000",
"number": "1518449172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1471",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041041471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023134",
"telephone_number": "207-662-2801"
}
],
"practiceLocations": [
{
"address_1": "50 Boulder Way",
"address_purpose": "LOCATION",
"city": "Biddeford",
"state": "ME",
"postal_code": "040059442",
"country_code": "US",
"telephone_number": "207-286-9562",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUNDY",
"first_name": "JORDAN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-30",
"last_updated": "2018-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NH",
"license": "PHCY-04371",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ME",
"license": "PR46968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.